Southwest Iom Pro LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

SOUTHWEST IOM PRO LLC

Practice address

6401 E Caron Dr
Paradise Valley, AZ 85253-1862

Phone

(623) 293-3985

NPI assigned

Jun 12, 2020

Organization subpart

No

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

Authorized official

Name

Christopher S Ray, MD

Title

President

Phone

(623) 293-3985

Specialties & licenses 1

Addresses

Other names 1

• SOUTHWEST IOM PRO LLC Former legal business name

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1801411152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 E CARON DR",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531862",
            "telephone_number": "623-293-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 E CARON DR",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531862",
            "telephone_number": "623-293-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST IOM PRO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-293-3985",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHWEST IOM PRO LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Peter J Smith, D.C.,
• William Smith Jr., MD
• Emily Broghan Schutsky Snyder, NP
• Tyler John Southwell, M.D.
• Southwellness Medical LLC
• Southwest Iom, LLC
• Jerry Preston Sparks, DDS
• Speech America Learning Associate, Inc.
• Robert J. Spies, MD
• St. Sophie'S, LLC

• Neurology Physician in Paradise Valley, AZ
• Providers in Paradise Valley, 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 12, 2020; 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.