BANNER SCHOOL BASED CLINIC (NPI# 1033594247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033594247 |
| Entity Type | Organization |
| Organization Name | BANNER SCHOOL BASED CLINIC |
| Practice Address |
855 W 8th Ave Mesa AZ 85210-3401 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 4804721112 |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-29 |
| Authorized Official Name | DENNIS DAHLEN (SR VP FINANCE) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
855 W 8TH AVE |
| City | MESA |
| State | AZ |
| Zip Code | 85210-3401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134268626 | Scott Bruce Nelson | Psychologist | 855 W 8th Ave, Mesa, AZ 85210-3401 | 2007-02-05 |
| 1205058997 | Virginia L Backman | Nurse Practitioner | 855 W 8th Ave, Mesa, AZ 85210-3401 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790337665 | Banner Physician Super Specialists Arizona LLC | Clinic/Center | 1450 S Dobson Rd Ste B221, Mesa, AZ 85202-4745 | 2019-07-11 |
| 1558836270 | Cardiac Cath Lab of Mesa, LLC | Clinic/Center | 4555 E Inverness Ave Ste 1, Mesa, AZ 85206-4630 | 2018-10-09 |
| 1477095735 | Mckellips Internal Medicine Pllc | Clinic/Center | 3049 E Mckellips Rd Ste 5, Mesa, AZ 85213-3144 | 2016-11-17 |
| 1558365536 | Shannon Gray | Clinic/Center | 605 N Gilbert Rd, Mesa, AZ 85203-6629 | 2005-06-08 |
| 1407191216 | Banner Childrens Banner Health Clinic LLC | Clinic/Center | 1220 S Higley Rd Ste 101, Mesa, AZ 85206-4001 | 2012-12-05 |
| 1841573870 | Banner Physician Super Specialists Arizona LLC | Clinic/Center | 1432 S Dobson Rd, Mesa, AZ 85202-4768 | 2011-09-26 |
| 1639323447 | Banner Pediatric Specialists LLC | Clinic/Center | 1432 S Dobson Rd, Mesa, AZ 85202-4768 | 2008-11-06 |
| 1487814240 | Phoenix Children's Medical Group | Clinic/Center | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2008-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254918 | Assyrian Family Health Alliance | Clinic/Center | 10210 N 32nd St Ste C6, Phoenix, AZ 85028-3826 | 2020-10-26 |
| 1659970242 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33300 N 32nd Ave, Phoenix, AZ 85085-8877 | 2020-10-23 |
| 1689273542 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33400 N 32nd Ave Fl 1, Phoenix, AZ 85085-8876 | 2020-10-21 |
| 1629676317 | Bethel Hills Integrated Healthcare | Clinic/Center | 13838 S 46th Pl Ste 300, Phoenix, AZ 85044-7804 | 2020-10-14 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| 1235745464 | Vasco Healthcare Inc | Clinic/Center | 2110 W 24th St Ste A, Yuma, AZ 85364-8878 | 2020-09-22 |
| 1265048490 | Vasco Healthcare Inc | Clinic/Center | 8952 E Desert Cove Ave Ste 204, Scottsdale, AZ 85260-6777 | 2020-09-22 |
| 1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BANNER SCHOOL BASED CLINIC.
| 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.