BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS WOMEN'S SERVICES (NPI# 1881623643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881623643 |
Entity Type | Organization |
Organization Name | BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS WOMEN'S SERVICES |
Practice Address |
1300 N 12th St Suite 407 Phoenix AZ 85006-2848 |
Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
Practice Telephone | 6022394915 |
Enumeration Date | 2006-07-02 |
Last Update Date | 2015-02-26 |
Authorized Official Name | DENNIS DAHLEN (SR VICE PRESIDENT 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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 767650 | 05 |
Street Address |
1300 N 12TH ST SUITE 407 |
City | PHOENIX |
State | AZ |
Zip Code | 85006-2848 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831192590 | William Walter Holland | Family Medicine | 1300 N 12th St, Suite 605, Phoenix, AZ 85006-2848 | 2005-05-24 |
1699235127 | Mary Mihalko | Student in an Organized Health Care Education/Training Program | 1300 N 12th St, Phoenix, AZ 85006-2848 | 2019-03-21 |
1447779608 | Sara Marie Sorace | Physician Assistant | 1300 N 12th St, Phoenix, AZ 85006-2848 | 2017-09-19 |
1104350990 | Hillary Tamar | Student in an Organized Health Care Education/Training Program | 1300 N 12th St, Suite 605, Phoenix, AZ 85006-2848 | 2017-04-18 |
1669906459 | Michelle Sommer | Family Medicine | 1300 N 12th St, Suite 605, Phoenix, AZ 85006-2848 | 2017-04-18 |
1922532712 | Herbert Rosenbaum | Student in an Organized Health Care Education/Training Program | 1300 N 12th St, Suite 605, Phoenix, AZ 85006-2848 | 2017-04-18 |
1992239909 | Karalyne Blochberger | Family Medicine | 1300 N 12th St, Suite 605, Phoenix, AZ 85006-2848 | 2017-04-17 |
1104350123 | Akua Ekunwe | Family Medicine | 1300 N 12th St, Suite 605, Phoenix, AZ 85006-2848 | 2017-04-17 |
1073047098 | Viktoria Krajnc | Family Medicine | 1300 N 12th St, Suite 605, Phoenix, AZ 85006-2848 | 2017-04-17 |
1568995876 | Stefanie Handrick Brichta | Student in an Organized Health Care Education/Training Program | 1300 N 12th St, Suite 320, Phoenix, AZ 85006-2848 | 2017-04-04 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356949929 | Teresa Louise Cox | Pharmacist | 1800 E Van Buren St., St. Luke's Behavioral Health, Phoenix, AZ 85006 | 2020-10-15 |
1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
1023638582 | Supraja Prakash | Genetic Counselor, MS | 1920 E Cambridge Ave., Rosenberg Bldg., Suite 304, Phoenix, AZ 85006 | 2020-04-24 |
1760017099 | Phoenix Medical Psychiatric Hospital, LLC | Psychiatric Hospital | 1346 Mcdowell Road, Phoenix, AZ 85006 | 2020-03-06 |
1265093108 | Zulianna Ibrahim | Student in an Organized Health Care Education/Training Program | Banner University Medical Center Phoenix Family Medicin, 1300 N. 12th Street Suite 605, Phoenix, AZ 85006 | 2019-06-21 |
1306318340 | Leah Margaret Hillier | Family Medicine | 1300 N 12th St - Suite 500, Phoenix, AZ 85006 | 2018-12-31 |
1477032357 | Joann Moskop | Chiropractor | 2719 N Greenfield Rd., Phoenix, AZ 85006 | 2018-08-10 |
1619464468 | Ana Maria Lara | Naturopath | 926 E Mcdowell Rd Ste 204, Phoenix, AZ 85006 | 2018-04-17 |
1194221770 | Nisha Bharat Patel | Student in an Organized Health Care Education/Training Program | Edwards Medical Plaza Suite 320, 1300 North 12th Street, Phoenix, AZ 85006 | 2018-04-03 |
1710486352 | Julia Cyr | Registered Nurse | 1008 E Mcdowell Rd Unit A, Phoenix, AZ 85006 | 2018-02-09 |
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Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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1508325929 | Ican America | Clinic/Center | Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 | 2019-03-15 |
1043790801 | United Rcm LLC | Clinic/Center | 1202 E Alta Vista Rd, Phoenix, AZ 85042-4432 | 2018-08-20 |
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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.