BANNER -- UNIVERSITY MEDICAL CENTER SOUTH CAMPUS LLC (NPI# 1801284617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801284617 |
| Entity Type | Organization |
| Organization Name | BANNER -- UNIVERSITY MEDICAL CENTER SOUTH CAMPUS LLC |
| Practice Address |
2800 E Ajo Way Tucson AZ 85713-6204 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 5208742000 |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2017-11-14 |
| Authorized Official Name | MATTHEW COX (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 | 273R00000X | Psychiatric Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MEDICARE | 03S111 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922660182 | Banner -- University Medical Center South Campus LLC | Clinic/Center | 3950 S Country Club Rd Ste 130&140, Tucson, AZ 85714-2099 | 2019-07-08 |
| 1558759498 | Banner -- University Medical Center South Campus LLC | General Acute Care Hospital | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2014-12-30 |
| Street Address |
2800 E AJO WAY |
| City | TUCSON |
| State | AZ |
| Zip Code | 85713-6204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033105002 | Andrzej Honory | Psychiatry & Neurology | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2005-09-23 |
| 1962002584 | Carly Rae Moskowitz | Student in an Organized Health Care Education/Training Program | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2020-11-01 |
| 1730794207 | Rachel Ramirez | Nurse Practitioner | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2020-09-11 |
| 1356953954 | Johnathan Mougin | Registered Nurse | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2020-08-17 |
| 1689282279 | Armaan Dhaliwal | Internal Medicine | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2020-07-20 |
| 1881212264 | Anas Husni Mohamad Abu Assi | Internal Medicine | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2020-07-11 |
| 1801413620 | Niharika Vennelaganti | Internal Medicine | 2800 E Ajo Way, Tucson, AZ 85713 | 2020-06-26 |
| 1134740970 | Anirudh Tadakamalla | Internal Medicine | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2020-05-04 |
| 1225659287 | Sakher Yousef Mahmoud Sarairah | Internal Medicine | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2020-04-30 |
| 1578184537 | Brian Schiffman | Internal Medicine | 2800 E Ajo Way, Tucson, AZ 85713-6204 | 2020-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679115489 | Eric James Mccracken | Nurse Practitioner | 1230 South Cherrybell Stravanue, Tucson, AZ 85713 | 2019-10-14 |
| 1336702448 | Julie Tomkins | Psychiatry & Neurology | Behavioral Health Pavilion, 2800 E Ajo Way, Tucson, AZ 85713 | 2019-04-16 |
| 1861958332 | El Rio Santa Cruz Neighborhood Health Center, Inc | Pharmacy | 1230 S Cherrybell Strav, Tucson, AZ 85713 | 2019-02-20 |
| 1164993002 | Lisa Ann Lindsay | Nurse Practitioner | 1230 S Cherrybell Stravenue, Tucson, AZ 85713 | 2018-12-17 |
| 1043701717 | Ramsha Saeed Rao | Student in an Organized Health Care Education/Training Program | Maria Jennings 2800 E. Ajo Way, Tucson, AZ 85713 | 2018-05-29 |
| 1215381736 | Nancy G Larison | Counselor | 504 W 29th Street, La Frontera Center, Inc., Tucson, AZ 85713 | 2016-04-21 |
| 1053791749 | Eric Lederer | Emergency Medicine | 3950 S. Country Club Rd, Ste. 200, Tucson, AZ 85713 | 2015-06-08 |
| 1942625025 | Eugene Randolph Shields | Obstetrics & Gynecology | 2315 W. Ocelot Drive, Tucson, AZ 85713 | 2014-02-26 |
| 1821361973 | Irene A Laventure | Nurse Practitioner | 2800 East Ajo Way, University of Arizona Medical Center - South Campus, Tucson, AZ 85713 | 2012-02-21 |
| 1386917417 | Caring Together,llc | Respite Care | 2957 E 24th Street, Tucson, AZ 85713 | 2012-02-21 |
| Find all providers in zip 85713 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417032145 | Carondelet Health Network | Psychiatric Unit | 1601 West St Mary's Road, Tucson, AZ 85745-2623 | 2006-10-25 |
| 1609957141 | Carondelet Health Network | Psychiatric Unit | 1601 W St Mary's Road, Tucson, AZ 85745-2623 | 2006-10-18 |
| 1750462107 | Carondelet Health Network | Psychiatric Unit | 1802 West St. Mary's Road, Tucson, AZ 85745-2623 | 2006-10-18 |
| 1073614905 | Lafrontera Center Inc. | Psychiatric Unit | 1601 E. Apache Park Place, Tucson, AZ 85714 | 2006-09-25 |
| 1720454341 | Smsj Tucson Holdings LLC | Psychiatric Unit | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2015-08-18 |
| 1801262423 | Smsj Tucson Holdings LLC | Psychiatric Unit | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2015-08-18 |
| 1750788667 | Carondelet Health Network | Psychiatric Unit | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2014-11-21 |
| 1417361239 | Tucson Medical Center | Psychiatric Unit | 2221 N Rosemont Blvd, Tucson, AZ 85712-2113 | 2014-06-19 |
| 1417290958 | Carondelet Health Network | Psychiatric Unit | 350 N Wilmot Rd, Suite 150-23a, Tucson, AZ 85711-2602 | 2013-04-03 |
| 1841435187 | Pima Psychiatric Associates, Inc. | Psychiatric Unit | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2008-12-15 |
| Find all providers in TUCSON | ||||
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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.