Organization Active NPI

Sud LLC

  • Addiction Medicine (Preventive Medicine) Physician
  • Phoenix, AZ
National Provider Identifier
1821854712
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
Legal business name
SUD LLC
Practice address
4919 E Hazel Dr Unit 1
Phoenix, AZ 85044-7776
Phone
(602) 431-1152
NPI assigned
Feb 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Kirsten A Sorensen
Title
Administrator
Phone
(602) 388-1180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083A0300X Primary

Addresses

Primary practice location

4919 E Hazel Dr Unit 1
Phoenix, AZ 85044-7776

Mailing address

4919 E Hazel Dr Unit 1
Phoenix, AZ 85044-7776
Phone (602) 431-1152

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1821854712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 E HAZEL DR UNIT 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447776",
            "telephone_number": "602-431-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4919 E HAZEL DR UNIT 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447776",
            "telephone_number": "602-431-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-27",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-388-1180"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.