BANNER CANCER CENTER SPECIALISTS COLORADO LLC (NPI# 1073096475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073096475 |
| Entity Type | Organization |
| Organization Name | BANNER CANCER CENTER SPECIALISTS COLORADO LLC |
| Practice Address |
1801 16th St Greeley CO 80631-5154 |
| Mailing Address |
2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 |
| Practice Telephone | 9708104121 |
| Practice Fax Number | 9703506140 |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-09-11 |
| Authorized Official Name | DENNIS LARAWAY (CFO) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER MEDICAL GROUP COLORADO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0200X |
Clinic/Center Specialization: Oncology |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942783089 | Banner Cancer Center Specialists Colorado LLC | Clinic/Center | 1800 15th St Ste A, Greeley, CO 80631-4595 | 2018-09-14 |
| 1932682077 | Banner Cancer Center Specialists Colorado LLC | Clinic/Center | 2050 Boise Ave Unit B, Loveland, CO 80538-5036 | 2018-09-14 |
| 1962985366 | Banner Cancer Center Specialists Colorado LLC | Clinic/Center | 2000 Boise Ave, Loveland, CO 80538-5006 | 2018-09-11 |
| Street Address |
1801 16TH ST |
| City | GREELEY |
| State | CO |
| Zip Code | 80631-5154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649252867 | Ronald E Baars | Pharmacist | 1801 16th St, Greeley, CO 80631-5154 | 2005-11-15 |
| 1710585500 | Colten M Bray | Nurse Practitioner | 1801 16th St, Greeley, CO 80631-5154 | 2020-10-13 |
| 1588271340 | Becky Lynn Evans | Nurse Practitioner | 1801 16th St, Greeley, CO 80631-5154 | 2020-09-25 |
| 1780290452 | Healthone Clinic Services - Pediatric Specialties LLC | Pediatrics | 1801 16th St, Greeley, CO 80631-5154 | 2020-09-18 |
| 1023624723 | Jarah Adrianna Grashorn | Social Worker | 1801 16th St, Greeley, CO 80631-5154 | 2020-09-17 |
| 1972112035 | Healthone Clinic Services - Cardiovascular LLC | Internal Medicine | 1801 16th St, Greeley, CO 80631-5154 | 2020-07-24 |
| 1831715747 | Sarah Bean | Specialist/Technologist, Other | 1801 16th St, Greeley, CO 80631-5154 | 2020-06-17 |
| 1457975435 | Antonio Costantini | Nurse Anesthetist, Certified Registered | 1801 16th St, Greeley, CO 80631-5154 | 2020-06-04 |
| 1376167569 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 1801 16th St, Greeley, CO 80631-5154 | 2020-06-03 |
| 1508480989 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 1801 16th St, Greeley, CO 80631-5154 | 2020-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395743 | Marcia Martinez | Peer Specialist | 1700 N 17th Ave, Greeley, CO 80631 | 2020-01-14 |
| 1073083036 | Ryan Lawhead | Specialist/Technologist | 270 Alles Dr. D, Butler Hancock Athletic Center, Greeley, CO 80631 | 2018-12-03 |
| 1447766647 | Patricia G Ferguson | Counselor | 14272 Wcr 72, Greeley, CO 80631 | 2017-12-26 |
| 1760902662 | Robert Anthony Rexroad | Counselor | 1300 N. 17th Avenue, Greeley, CO 80631 | 2017-06-21 |
| 1326577750 | Danielle Rodriguez | Psychologist | 1300 N. 17th Ave, Greeley, CO 80631 | 2017-06-08 |
| 1790157865 | Safeway | Pharmacy | 3526 W 10th Street, Greeley, CO 80631 | 2015-10-28 |
| 1245574508 | Jayme L Clapp | Counselor | 1407 8th Ave, Greeley, CO 80631 | 2012-11-26 |
| 1114246006 | Cynthia Melissa Gitler | Emergency Medicine | Banner Health, North Colorado Medical Center, 1601 18th Street, Greenley, CO 80631 | 2010-05-18 |
| 1942438023 | Khoi Dinh Le | Surgery | 1800 15th St., Suite 200, Greeley, CO 80631 | 2009-06-26 |
| 1174760011 | Darwin James Hargrave | Counselor | 912 9th Ave., #222, Greeley, CO 80631 | 2009-01-14 |
| Find all providers in zip 80631 | ||||
| Taxonomy Code | 261QX0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942783089 | Banner Cancer Center Specialists Colorado LLC | Clinic/Center | 1800 15th St Ste A, Greeley, CO 80631-4595 | 2018-09-14 |
| 1942513965 | Banner Oncology Services | Clinic/Center | 1800 15th St, Suite A, Greeley, CO 80631-4500 | 2010-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831738061 | National Jewish Health | Clinic/Center | National Jewish North, 9451 Huron Street, Thornton, CO 80260-5426 | 2020-01-06 |
| 1609268663 | Rocky Mountain Cancer Center | Clinic/Center | 8288 Dove Ridge Way, Parker, CO 80134-8893 | 2015-02-28 |
| 1356987630 | Hca-healthone, LLC | Clinic/Center | 7180 E Orchard Rd Ste 103, Centennial, CO 80111-1725 | 2019-11-21 |
| 1932682077 | Banner Cancer Center Specialists Colorado LLC | Clinic/Center | 2050 Boise Ave Unit B, Loveland, CO 80538-5036 | 2018-09-14 |
| 1962985366 | Banner Cancer Center Specialists Colorado LLC | Clinic/Center | 2000 Boise Ave, Loveland, CO 80538-5006 | 2018-09-11 |
| 1346534658 | Banner Oncology Services | Clinic/Center | 120 Old Laramie Trl E, Lafayette, CO 80026-7012 | 2011-06-03 |
| 1508166117 | Banner Oncology Services | Clinic/Center | 615 Fairhurst St, Sterling, CO 80751-4523 | 2010-10-28 |
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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.