Sovereign Phoenix

Primary specialty

ContractorTaxonomy code 171W00000X

Legal business name

SOVEREIGN PHOENIX

Practice address

15 Cuttermill Rd
Great Neck, NY 11021-3252

Phone

(516) 303-0967

NPI assigned

Jul 8, 2014

Last updated

Jul 8, 2014By 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

Tyrone BarnettNPI 1174291306

Title

Owner

Phone

(516) 303-0967

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Tyrone Barnett

  • Contractor
  • New York, NY
  • NPI 1174291306
  NPD Authorized official

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1871909093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CUTTERMILL RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CUTTERMILL RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213252",
            "telephone_number": "516-303-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN PHOENIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-303-0967"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan S. Sorett, M.D.
• Melissa Souferian
• Soundview Medical Group, PLLC
• Sadaf Souri
• South Station Pharmacy Inc
• Daria Sowa, OTR/L
• Michael W Spanakos, DC
• Erin Spector, P.A.
• Juval Spector, D.D.S
• Ruth Spector, M.D.

• Contractor in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Contractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.