NPIMap

Organization Active NPI

Southwest Center for Neurological Surgeons PC

  • Specialist
  • Mesa, AZ
National Provider Identifier
1891901088
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
18410 Issued in AZ
Legal business name
SOUTHWEST CENTER FOR NEUROLOGICAL SURGEONS PC
Practice address
4566 E Inverness Ave
205
Mesa, AZ 85206-4633
Phone
(480) 730-1844
Fax
(480) 730-1404
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Marc Alain Letellier, MD
Title
Owner
Phone
(480) 730-1844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 18410 AZ Primary

Addresses

Primary practice location

4566 E Inverness Ave
205
Mesa, AZ 85206-4633

Mailing address

4566 E Inverness Ave
205
Mesa, AZ 85206-4633
Phone (480) 730-1844

National Provider Directory

National Provider Directory

Locations

4566 E Inverness Ave
Ste 2
Mesa, AZ 85206
Phone (480) 730-1844

4566 E Inverness Ave
Ste 205
Mesa, AZ 85206
Phone (480) 640-0513

Practitioners & affiliated clinicians

Practitioners 10

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": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891901088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 E INVERNESS AVE",
            "address_2": "205",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064633",
            "telephone_number": "480-730-1844",
            "fax_number": "480-730-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 E INVERNESS AVE",
            "address_2": "205",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064633",
            "telephone_number": "480-730-1844",
            "fax_number": "480-730-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST CENTER FOR NEUROLOGICAL SURGEONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LETELLIER",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "ALAIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-730-1844",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "18410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.