Southwest Ear, Nose & Throat, PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

SOUTHWEST EAR, NOSE & THROAT, PLLC

Practice address

1760 McCulloch Blvd N Ste 102
Lake Havasu City, AZ 86403-6559

Phone

(928) 453-0303

Fax

(928) 453-0338

NPI assigned

Mar 27, 2020

Last updated

Mar 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Prater, MDNPI 1598723173

Title

Owner / Member Manager

Phone

(928) 453-0303

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Edward Prater, M.D.

  • Otolaryngology Physician
  • Lake Havasu City, AZ
  • NPI 1598723173
  Medicare reassignment NPD Authorized official
• Adrienne A Prater

  • Hearing Instrument Specialist
  • Lake Havasu City, AZ
  • NPI 1366123325
  NPD

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1861020703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 MCCULLOCH BLVD N STE 102",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036559",
            "telephone_number": "928-453-0303",
            "fax_number": "928-453-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 MCCULLOCH BLVD N STE 102",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036559",
            "telephone_number": "928-453-0303",
            "fax_number": "928-453-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST EAR, NOSE & THROAT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "PRATER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER / MEMBER MANAGER",
        "authorized_official_telephone_number": "928-453-0303",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Solomon, AGNP-C
• Somewhere Out of the Box (Milemarkers)
• Catherine Evelyn Sondrol, MOTRL
• Edouard Sorkin, DDS
• Southwest Behavioral Health Services, Inc.
• Southwest Ear, Nose, & Throat Specialists
• Southwest Surgery, L.L.C.
• Southwest Surgery, LLC
• Rian William Spear, PHARMD
• Peter Walmy St Louis Angervil

• Otolaryngology Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Otolaryngology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.