SOUTHWEST I.D. & MEDICAL CLINIC, LC
NPI 1275563975
Internal Medicine - Infectious Disease in Prescott Valley, AZ

Q: What is Southwest I.D. & Medical Clinic, Lc's NPI number?

The NPI number for Southwest I.D. & Medical Clinic, Lc is 1275563975. It was assigned to this organization in the NPPES registry on July 5, 2006.

Q: What is Southwest I.D. & Medical Clinic, Lc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Active since July 05, 2006CLIA 03D2056808 · Waiver

3235 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314(928) 772-3340(928) 759-9611 Get Directions Write a Review

NPPES record last updated: September 7, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Southwest I.d. & Medical Clinic, Lc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHWEST I.D. & MEDICAL CLINIC, LC (NPI 1275563975) is a healthcare organization registered as an infectious disease in Prescott Valley, Arizona and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 3, 2027 and lists Alpana Jetly, Manager, as its authorized official.

NPPES Registry Identity

NPI1275563975

Entity TypeOrganization

Primary Taxonomy207RI0200X

Legal Business NameSOUTHWEST I.D. & MEDICAL CLINIC, LC

Location Address3235 N WINDSONG DRPrescott Valley, AZ 86314-1222

Mailing AddressPo Box 1629Prescott, AZ 86302-1629 · (928) 772-3340

Phone(928) 772-3340

Fax(928) 759-9611

Organization SubpartNo

Authorized OfficialAlpana JetlyManager · (928) 772-3340

Enumeration DateJuly 5, 2006

Last NPPES UpdateSeptember 7, 2023

NPPES CertifiedSeptember 7, 2023

✔ NPI 1275563975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RI0200X

License✔ Licensed in AZ · 29064

Definition

An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

3235 N WINDSONG DR, Prescott Valley, AZ 86314

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2056808

Southwest Id & Med Clinic · Prescott Valley, AZ

Active · expires Apr 3, 2027

CLIA Number03D2056808

Laboratory TypePhysician Office

Certificate Effective DateApril 4, 2025

Certificate Expiration DateApril 3, 2027

Laboratory DirectorAlpana Jetly

Laboratory Phone(928) 772-3340

Laboratory LocationSouthwest Id & Med Clinic3235 N Windsong Dr, Prescott Valley, AZ 86314

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. ANGELA MARIE GONZALEZ FNP-BC

Nurse Practitioner (Family)

3235 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314

Yavapai County (928) 772-3340

DR. RAJIV JETLY M.D.

Internal Medicine

3235 N WINDSONG DR
PRESCOTT VALLEY, AZ 86314

Yavapai County (928) 772-3340

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southwest I.D. & Medical Clinic, Lc's NPI number?

The NPI number for Southwest I.D. & Medical Clinic, Lc is 1275563975. It was assigned to this organization in the NPPES registry on July 5, 2006.

Where is Southwest I.D. & Medical Clinic, Lc located?

Southwest I.D. & Medical Clinic, Lc is located at 3235 N Windsong Dr, Prescott Valley, AZ 86314. The listed phone number is (928) 772-3340.

What is Southwest I.D. & Medical Clinic, Lc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Does Southwest I.D. & Medical Clinic, Lc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2056808) is associated with this NPI, valid through April 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southwest I.D. & Medical Clinic, Lc accept?

Health plans from Ambetter from Arizona Complete Health list Southwest I.D. & Medical Clinic, Lc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southwest I.D. & Medical Clinic, Lc was last updated on September 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.