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Export Provider Record NPI 1104122621
Southwest Neurology And Sleep Medicine Llc
Organization Subpart: YES
Active
NPI Number1104122621
NPI TypeNPI-2 Organization
SpecialtyPsychiatry & Neurology, Neurology
Provider Details
NPI1104122621
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2011-01-31
Last Updated2019-04-23
Authorized OfficialSumaira Doorani
Manager
Phone: 6027725770
Mailing Address2401 W Glendale Ave Ste 203
Phoenix, AZ 85021-7677
United States
Phone: (602) 772-5770 | Fax: (602) 772-5771
📍 View Map
Primary Practice Address2401 W Glendale Ave Ste 203
Phoenix, AZ 85021-7677
United States
Phone: (602) 772-5770 | Fax: (602) 772-5771
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDWA8293938
Other (non-Medicare)AZZ143146ptan
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207Q00000X – Family Medicine
No207QS1201X – Family Medicine, Sleep Medicine
Yes2084N0400X – Psychiatry & Neurology, Neurology
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About NPI 1104122621

Southwest Neurology And Sleep Medicine Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1104122621. The primary specialty listed is Psychiatry & Neurology, Neurology. The organization is located in Phoenix, AZ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2011-01-31. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1104122621?

NPI 1104122621 belongs to Southwest Neurology And Sleep Medicine Llc, a Psychiatry & Neurology, Neurology in Phoenix, AZ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1104122621 active?

The current status of NPI 1104122621 in the NPPES registry is Active. The record was last updated on 2019-04-23.

What specialty is NPI 1104122621?

NPI 1104122621 is classified under the taxonomy Psychiatry & Neurology, Neurology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1104122621?

You can verify NPI 1104122621 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1104122621?

The primary practice address on file for NPI 1104122621 is 2401 W Glendale Ave Ste 203, Phoenix, AZ 85021-7677. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1104122621 issued?

NPI 1104122621 was first issued (enumerated) on 2011-01-31. The NPPES record was last updated on 2019-04-23.

Practice Location Map

Southwest Neurology And Sleep Medicine Llc is located at 2401 W Glendale Ave Ste 203, Phoenix, AZ. Use the map below to find directions or verify the practice location.

📍 2401 W Glendale Ave Ste 203, Phoenix, AZ 85021-7677  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Southwest Neurology And Sleep Medicine Llc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-25 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162