BANNER PHYSICIAN SPECIALISTS ARIZONA LLC (NPI# 1821368218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821368218 |
| Entity Type | Organization |
| Organization Name | BANNER PHYSICIAN SPECIALISTS ARIZONA LLC |
| Practice Address |
10150 N 67th Ave Ste 101 Glendale AZ 85302-1004 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 6238763940 |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-05-14 |
| Authorized Official Name | DENNIS E DAHLEN (SR VP FINANCE) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER MEDICAL GROUP ARIZONA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 646505 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366799355 | Banner Physician Specialists Arizona LLC | Clinic/Center | 601 N Navajo, Page, AZ 86040 | 2012-08-08 |
| 1033730429 | Banner Physician Specialists Arizona LLC | Clinic/Center | 501 N Navajo Dr, Page, AZ 86040-0959 | 2020-04-27 |
| 1750929949 | Banner Physician Specialists Arizona LLC | Clinic/Center | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2019-12-18 |
| 1801160569 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 9305 W Thomas Rd, Ste 405, Phoenix, AZ 85037-3328 | 2012-02-28 |
| 1275802829 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 13760 N 93rd Ave, Peoria, AZ 85381-4201 | 2011-12-27 |
| 1679842223 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 14420 W Meeker Blvd, Ste 104, Sun City West, AZ 85375-5286 | 2011-12-27 |
| 1588933139 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2011-12-27 |
| 1548538069 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 14416 W Meeker Blvd, Sun City West, AZ 85375-5284 | 2011-12-12 |
| 1992073498 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 13640 N Plaza Del Rio Blvd, Ste 120, Peoria, AZ 85381-4846 | 2011-12-12 |
| 1316228802 | Banner Physician Specialists Arizona LLC | Clinic/Center | 37100 N Gantzel Rd, Ste 107, San Tan Valley, AZ 85140-7349 | 2011-08-29 |
| Street Address |
10150 N 67TH AVE STE 101 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85302-1004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033119581 | John Mark Heyer | Family Medicine | 10150 N 67th Ave, Suite 101, Glendale, AZ 85302-1004 | 2005-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736190 | Tyler Davis LLC | Psychologist | 8607 N 59th Ave Suite C-6, Glendale, AZ 85302 | 2020-10-05 |
| 1679098420 | Sidney M Kingery | Physical Therapist | 5810 W Peoria Ave, Glendale, AZ 85302 | 2017-08-12 |
| 1255877825 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 5651 W. Harmont Dr, Glendale, AZ 85302 | 2017-01-06 |
| 1346696382 | Megan Mari Byrne | Chiropractor | 8425 N 61st Dr., Glendale, AZ 85302 | 2016-05-09 |
| 1558742007 | Farzan Mojgani | Dentist | 5929 W. Peoria Ave. Suite 101, Glendale, AZ 85302 | 2015-06-10 |
| 1255757308 | Glendale Modern Dentistry, LLP | Dentist | 5143 West Olive Ave, Suite 140, Glendale, AZ 85302 | 2014-03-13 |
| 1518391341 | Crystal Nicole-marie Whitman | Physical Therapy Assistant | 5411 W. Cinnabar Ave., Glendale, AZ 85302 | 2013-08-28 |
| 1013349570 | A New Leaf | Clinic/Center | 8581 N 61st Ave, Building A, Suite 101-102, Glendale, AZ 85302 | 2013-08-06 |
| 1255602439 | Alicia S Fennemore | Specialist/Technologist | 352 E. Camelback Rd., Suite 102, Phoenix, AZ 85302 | 2012-01-20 |
| 1639306731 | Total Medical Care, LLC | Clinic/Center | 5048 W. Northern Avenue, Suite 105, Glendale, AZ 85302 | 2009-06-16 |
| Find all providers in zip 85302 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578125738 | Banner Physician Super Specialists Arizona LLC | Clinic/Center | 5310 W Thunderbird Rd Ste 214, Glendale, AZ 85306-4722 | 2019-07-08 |
| 1992136576 | Best Choice Medical | Clinic/Center | 541 W Colorado St Ste 206, Glendale, CA 91204-3640 | 2013-12-06 |
| 1134412323 | Riverside Fletcher Medical Group | Clinic/Center | 1915 W Glenoaks Blvd # 101, Glendale, CA 91201-1541 | 2011-05-20 |
| 1396903571 | The Massage Fix Inc | Clinic/Center | 3600 Ocean View Blvd, Suite 1, Glendale, CA 91208-1272 | 2008-05-24 |
| 1023208212 | Arrowhead Health Center & Spa, Pllc | Clinic/Center | 17100 W 67th Ave, 300, Glendale, AZ 85308-3605 | 2007-07-25 |
| 1376582775 | Columbia St Mary's Hospital Ozaukee, Inc. | Clinic/Center | 4425 N Port Washington Rd, Glendale, WI 53212-1082 | 2006-06-05 |
| 1831685320 | Healing Service Agency LLC | Clinic/Center | 17505 N 79th Ave Ste 203, Glendale, AZ 85308-8726 | 2018-07-08 |
| 1659735504 | Tulaya Wellness Corp | Clinic/Center | 6789 N Green Bay Ave, Glendale, WI 53209-3472 | 2016-04-07 |
| 1912379090 | Quick Med Center LLC | Clinic/Center | 5104 N 67th Ave, Glendale, AZ 85301 | 2015-10-28 |
| 1356571228 | Brand Medical Center | Clinic/Center | 620 N Brand Blvd, Suite 403, Glendale, CA 91203-4208 | 2009-07-24 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on BANNER PHYSICIAN SPECIALISTS ARIZONA LLC.
| 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.