NPIMap

Organization Active NPI

Southwest Pain & Spine Center LLC

  • Specialist
  • Queen Creek, AZ
National Provider Identifier
1811369358
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SOUTHWEST PAIN & SPINE CENTER LLC
Practice address
21321 E Ocotillo Rd
Suite M131
Queen Creek, AZ 85142-5996
Phone
(480) 636-1225
Fax
(480) 636-8890
NPI assigned
Oct 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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

Authorized official

Name
Kevin M Henry, MDNPI 1063490183
Title
Partner
Phone
(480) 636-1225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X AZ Primary

Addresses

Primary practice location

21321 E Ocotillo Rd
Suite M131
Queen Creek, AZ 85142-5996

Mailing address

21321 E Ocotillo Rd
Suite M131
Queen Creek, AZ 85142-5996
Phone (480) 636-1225

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1811369358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD",
            "address_2": "SUITE M131",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425996",
            "telephone_number": "480-636-1225",
            "fax_number": "480-636-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD",
            "address_2": "SUITE M131",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425996",
            "telephone_number": "480-636-1225",
            "fax_number": "480-636-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PAIN & SPINE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "480-636-1225",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.