BANNER -- UNIVERSITY PHYSICIAN SPECIALISTS LLC (NPI# 1063887727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063887727 |
| Entity Type | Organization |
| Organization Name | BANNER -- UNIVERSITY PHYSICIAN SPECIALISTS LLC |
| Practice Address |
17900 N Porter Rd Maricopa AZ 85138-4228 |
| Mailing Address |
2901 N Central Ave Phoenix AZ 85012-2700 |
| Practice Telephone | 5202332500 |
| Practice Fax Number | 5202332574 |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |
| Authorized Official Name | DENNIS DAHLEN (SR VP FINANCE) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER -- UNIVERSITY MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417312760 | Banner -- University Physician Specialists LLC | Clinic/Center | 501 N Navajo Dr, Page, AZ 86040 | 2015-12-30 |
| 1437529245 | Banner -- University Physician Specialists LLC | Clinic/Center | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2015-10-06 |
| Street Address |
17900 N PORTER RD |
| City | MARICOPA |
| State | AZ |
| Zip Code | 85138-4228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851392302 | Hiram A. Rivera Padilla | Internal Medicine | 17900 N Porter Rd, Maricopa, AZ 85138-4228 | 2005-08-09 |
| 1619589652 | Arielle Loeper | Family Medicine | 17900 N Porter Rd, Maricopa, AZ 85138-4228 | 2020-08-20 |
| 1760817050 | Rachel Hutzler | Nurse Practitioner | 17900 N Porter Rd, Maricopa, AZ 85138-4228 | 2013-09-05 |
| 1700144011 | Lindsay Leigh Allen | Obstetrics & Gynecology | 17900 N Porter Rd, Maricopa, AZ 85138-4228 | 2012-04-25 |
| 1760619191 | Erin Bradley Labesky-scoggin | Obstetrics & Gynecology | 17900 N Porter Rd, Maricopa, AZ 85138 | 2009-06-11 |
| 1821246091 | Dawn Medler Sorenson | Pediatrics | 17900 N Porter Rd, Maricopa, AZ 85138-4228 | 2008-08-30 |
| 1881875037 | Nurul Itqiyah Hariadi | Pediatrics | 17900 N Porter Rd, Maricopa, AZ 85138-4228 | 2007-11-15 |
| 1588777197 | Carrie Ann Lipp | Pediatrics | 17900 N Porter Rd, Maricopa, AZ 85138-4228 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202594 | Olugus Family Care | Psychologist | 44077 W. Palmen Dr., Maricopa, AZ 85138 | 2020-10-15 |
| 1154960722 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 41840 W Maricopa- Casa Grande Hwy, Maricopa, AZ 85138 | 2019-12-31 |
| 1780227413 | Gabriela Flores | Registered Nurse | 44150 W. Maricopa Casa Grande Hwy, Maricopa, AZ 85138 | 2019-10-25 |
| 1033752761 | Lizabeth Joy Stephens | Registered Nurse | 44150 West Maricopa-casa Grand Hwy., Maricopa, AZ 85138 | 2019-10-25 |
| 1922657964 | Cathy Jo Rogers | Registered Nurse | 18600 North Porter Road, Maricopa, AZ 85138 | 2019-09-11 |
| 1902463565 | Four Directions LLC | Respite Care | 37724 W Amalfi Ave, Maricopa, AZ 85138 | 2019-05-20 |
| 1972087013 | Kristina Donnay | Family Medicine | 41600 W Smith Enke Rd Ste 3, Maricopa, AZ 85138 | 2018-09-24 |
| 1861909657 | Four Directions LLC | Respite Care | 43989 W Wade Drive, Maricopa, AZ 85138 | 2018-01-03 |
| 1063939411 | Christina Kern | Specialist/Technologist | 42623 W. Colby Dr., Maricopa, AZ 85138 | 2017-08-26 |
| 1205357191 | Konadu Family | Community Based Residential Treatment Facility, Mental Illness | 40030 W Coltin Way, Maricopa, AZ 85138 | 2017-06-29 |
| Find all providers in zip 85138 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 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 |
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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.