SOUTHWEST WELLNESS GROUP, LLC (NPI# 1326660416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326660416 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST WELLNESS GROUP, LLC |
| Other Organization Name | SOUTHWEST WELLNESS GROUP |
| Practice Address |
1940 E Thunderbird Rd Ste 103 Phoenix AZ 85022-5760 |
| Practice Telephone | 4804780790 |
| Mailing Telephone | 4804780790 |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | DR. CHRISTOPHER RAY (PRESIDENT) |
| Authorized Official Telephone | 6232933985 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LA0401X |
Anesthesiology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Southwest Wellness Group | Doing Business As Name - Organization |
| Street Address |
1940 E THUNDERBIRD RD STE 103 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85022-5760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953830 | Vitafuse, LLC | Registered Nurse | 1940 E Thunderbird Rd Ste 103, Phoenix, AZ 85022-5760 | 2020-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528626074 | Keauna Olugu | Psychologist | 17249 N. 7th St, 1128, Phoenix, AZ 85022 | 2019-05-30 |
| 1215455498 | Kristi Etchechury | Occupational Therapy Assistant | 807 East Beck Lane, Phoenix, AZ 85022 | 2017-09-07 |
| 1871017103 | Julie Dale | Physical Therapist | 1910 E Kathleen Rd, Phoenix, AZ 85022 | 2017-07-28 |
| 1669994539 | Valley Wellness Center Pllc | Clinic/Center | 702 E Bell Rd Ste 112, Phoenix, AZ 85022 | 2017-07-12 |
| 1386001758 | Debbie Mulder | Behavioral Analyst | 2400 West Dunlap Ave., Suite 100, Glendale, AZ 85022 | 2016-01-15 |
| 1114383437 | Jean Fay King | Nurse Practitioner | 15409 N. 23rd St., Phoenix, AZ 85022 | 2016-01-04 |
| 1093050767 | Cheyanne Wilderness Gastelum | Midwife | 2236 E. Delgado St., Phoenix, AZ 85022 | 2012-12-06 |
| 1760731236 | Nicole Ann Raus | Occupational Therapy Assistant | 15414 N. 7th Street, Suite 3, Phoenix, AZ 85022 | 2012-08-30 |
| 1144593211 | Edward Najeeb Abraham | Family Medicine | 14419 N. 5th Place, Phoenix, AZ 85022 | 2012-02-20 |
| 1942506019 | Mirnes Mehic | Assisted Living Facility | 2018 E. Wagoner Rd., Phoenix, AZ 85022 | 2011-02-07 |
| Find all providers in zip 85022 | ||||
| Taxonomy Code | 207LA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Addiction Medicine |
| An anesthesiologist who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235466996 | The Grant Clinic, LLC | Anesthesiology | 14640 N Tatum Blvd Ste 7, Phoenix, AZ 85032-4824 | 2009-11-17 |
| 1740610039 | Atlantis Medical Group Az Pllc | Anesthesiology | 5501 N 19th Ave, Phoenix, AZ 85015-2450 | 2013-11-22 |
| 1659676401 | L Robert Reader Md PC | Anesthesiology | 4441 E Mcdowell Rd, Suite 101, Phoenix, AZ 85008-4503 | 2011-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699221879 | Gateway Addictionology Services, Pllc | Anesthesiology | 4862 E. Baseline Road, Suite 108, Mesa, AZ 85206 | 2016-08-29 |
| 1285030544 | Ernesto R Garcia | Anesthesiology | 3145 E Arroyo Chico, Tucson, AZ 85716-5808 | 2014-11-14 |
| 1841538311 | Atlantis Anesthesia Associates Az Pllc | Anesthesiology | 11124 W California Ave Ste F, Youngtown, AZ 85363-1246 | 2013-01-17 |
| 1295281863 | Kurefusion, Pllc | Anesthesiology | 4862 E. Baseline Road, Suite 108, Mesa, AZ 85206-4668 | 2016-09-01 |
| 1891173340 | Dependency Relief Specialists | Anesthesiology | 1452 N Higley Rd, Suite 101, Gilbert, AZ 85234-1610 | 2015-05-15 |
| 1528490968 | Grant Clinic LLC | Anesthesiology | 708 S Coeur D Alene Ln, Suite D, Payson, AZ 85541-5662 | 2013-08-08 |
| 1346558483 | Grant Clinic LLC | Anesthesiology | 708 S Coeur D Alene Ln, Suite D, Payson, AZ 85541-5662 | 2010-09-23 |
| 1174690606 | Rob Ashby | Anesthesiology | 115 S Mccormick St Ste 2, Prescott, AZ 86303-4738 | 2006-11-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.