OrganizationActive
Southwestern Pediatricspllc
NPI 1093033110 · Family Nurse Practitioner · Maricopa, AZ
Provider details
- NPI number
- 1093033110
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- Southwestern Pediatrics PLLC
- Organization subpart
- Yes
- Authorized official
- Kellie Denos, Front Office(480) 857-6316
- License
- AP3529 (AZ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
21300 N John Wayne Pkwy Ste 109
Maricopa, AZ 85139-8964
Phone: (520) 568-9500
Fax: (520) 568-9533
Street-level locationGet directions
Mailing address
21300 N John Wayne Pkwy Ste 109
Maricopa, AZ 85139-8964
Registry dates
- Enumerated
- 2010-05-13
- Last updated
- 2010-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.