PS Pro Iom LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

PS PRO IOM LLC

Practice address

3724 N 3Rd St Ste 301
Phoenix, AZ 85012-2035

Phone

(480) 634-6400

Fax

(480) 404-9649

NPI assigned

Jun 17, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Challen Waychoff III

Title

Coo/Manager

Phone

(480) 634-6400

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1760042220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 N 3RD ST STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122035",
            "telephone_number": "480-634-6400",
            "fax_number": "480-404-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 N 3RD ST STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122035",
            "telephone_number": "480-634-6400",
            "fax_number": "480-404-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PS PRO IOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "WAYCHOFF",
        "authorized_official_first_name": "CHALLEN",
        "authorized_official_title_or_position": "COO/MANAGER",
        "authorized_official_telephone_number": "480-634-6400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Leigh Przybyl, DNP, RN, ACCNS-AG
• Daniel Anthony Przygocki, DDS
• PS Clinics, LLC
• PS Clinics, LLC
• PS DME LLC
• PS Tech Iom LLC
• Jonathan Psenka, NMD
• Psych Zenhealth PLLC
• Psychiatric Services, L.L.C.
• Psychiatric Solutions LLC

• Neurology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Neurology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.