BANNER HEALTH (NPI# 1205267549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205267549 |
| Entity Type | Organization |
| Organization Name | BANNER HEALTH |
| Other Organization Name | BANNER HEALTH CLINIC |
| Practice Address |
1345 A Paul Bunyan Rd Susanville CA 96130-3159 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 5302522235 |
| Practice Fax Number | 5302522241 |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2014-04-11 |
| Authorized Official Name | DENNIS DAHLEN (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 | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Banner Health Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139004 | Banner Health | General Acute Care Hospital | 1405 S Alma School Rd, Chandler, AZ 85286 | 2020-03-20 |
| 1659787554 | Banner Health | General Acute Care Hospital | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2014-07-11 |
| 1942613435 | Banner Health | Clinic/Center | 1676 E Mcmurray Blvd Ste 1, Casa Grande, AZ 85122-4798 | 2014-06-03 |
| 1538402995 | Banner Health | Military Hospital | 2017 E Ruby Ln, Phoenix, AZ 85024-8617 | 2013-04-03 |
| 1407409964 | Banner Health | Hospice Care, Community Based | 2726 W 11th Street Rd, Greeley, CO 80634-5408 | 2019-07-23 |
| 1124532924 | Banner Health | Ambulance | 4700 Lady Moon Dr, Fort Collins, CO 80528-4426 | 2017-12-01 |
| 1063923340 | Banner Health | General Acute Care Hospital | 807 S Ponderosa St, Payson, AZ 85541-5542 | 2017-10-13 |
| 1912447855 | Banner Health | General Acute Care Hospital | 4259 S Squires Ln, Gilbert, AZ 85297-1206 | 2017-02-25 |
| 1851842892 | Banner Health | General Acute Care Hospital | 1801 16th St, Greeley, CO 80631-5154 | 2016-10-14 |
| 1154793131 | Banner Health | Clinic/Center | 2000 Boise Ave, Loveland, CO 80538-5006 | 2015-10-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | BANNER HEALTH | 2901 N Central Ave Suite 160, Phoenix, AZ 85012 |
| System for Award Management (SAM) Entities | BANNER HEALTH | 9201 W Thomas Rd, Phoenix, AZ 85037-3332 |
| Iowa Business Entities | BANNER HEALTH | 2901 N Central Ave Suite 160, Phoenix, AZ 85012 |
| Washington State Corporations | BANNER HEALTH | 2901 N Central Ave #160, Phoenix, AZ 85012 |
| New York State Corporations | BANNER HEALTH | 111 Eighth Avenue, 13th Floor, New York, Ny 10011 |
| Colorado Business Entities | Banner Health CCPHP, LLC | 530 Seventh Avenue Suite 2401, New York, NY 10018 |
| New York State Corporations | BANNER HEALTH CCPHP, LLC | 99 Washington Avenue Suite 1008, Albany, Ny 12260 |
| Colorado Business Entities | Banner Health Network | 2901 N Central Ave Ste 160, Phoenix, AZ 85012 |
| Colorado Business Entities | Banner Health Physicians-Colorado, LLC | 1801 16th Street, Greeley, CO 80631 |
| Virginia Business Entities | Banner HealthCare Solutions Inc. | 3671 Utica St., Denver, Colorado 80212 |
| Street Address |
1345 A PAUL BUNYAN RD |
| City | SUSANVILLE |
| State | CA |
| Zip Code | 96130-3159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932753456 | Shaughn Randall Whittaker | Nurse Practitioner | 1860 Paul Bunyan Rd, Susanville, CA 96130 | 2019-08-01 |
| 1871980847 | Katie Gaffney | Acupuncturist | 1850 Spring Ridge Dr., Susanville, CA 96130 | 2015-04-17 |
| 1952678435 | Linda Vixie | Dentist | 3020 Johnstonville Rd., Susanville, CA 96130 | 2011-11-28 |
| 1942503057 | Pamela Sue Vallalvazo | Counselor | 1445 Paul Bunyon Rd., Susanville, CA 96130 | 2010-12-10 |
| 1255631883 | Jessica Smyth | Counselor | 1400 Chestnut Street # A, Susanville, CA 96130 | 2010-10-29 |
| 1295045276 | Danielle Hardy | Counselor | 1400 Chestnut Street Suite A, Susanville, CA 96130 | 2010-10-08 |
| 1982921417 | Ronald Spencer Tucker Jr. | Counselor | 4119 Johnstonville Road, #270503, Susanville, CA 96130 | 2010-04-23 |
| 1609107945 | Timothy J Nolan | Psychologist | 803 1/2 Main St., Suite 104, Susanville, CA 96130 | 2010-01-27 |
| 1528243649 | Daniel Martin Bruce | Case Manager/Care Coordinator | 720-a Richmond Road, Susanville, CA 96130 | 2008-01-08 |
| 1679757785 | Michael Charles Giddings | Dentist | 475 Rice Canyon Rd, Susanville, CA 96130 | 2007-12-26 |
| Find all providers in zip 96130 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720463961 | Banner Lassen Medical Center | Clinic/Center | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2015-07-29 |
| 1881950541 | Banner Health Physicians West LLC | Clinic/Center | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2012-04-06 |
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| 1164039020 | Crossover Health Medical Group | Clinic/Center | 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 | 2020-09-24 |
| 1104432673 | Aleracare Medical Group of California | Clinic/Center | 17777 Ventura Blvd Ste 220, Encino, CA 91316-3748 | 2020-09-21 |
| 1205447687 | Shawn Richard Oneill | Clinic/Center | 5979 Trotters Ln, Alta Loma, CA 91701-2644 | 2020-08-11 |
| 1134738032 | Healthworks Med Group of California A Medical Corporation | Clinic/Center | 2821 Scott Blvd Ste 2126, Santa Clara, CA 95050-2549 | 2020-07-27 |
| 1437767951 | Miro Health | Clinic/Center | 260 King St Unit 1505, San Francisco, CA 94107-6415 | 2020-07-21 |
| 1598383895 | Alacrity Patient Services, Inc. | Clinic/Center | 1002 N Hudson Ave Apt 1, Los Angeles, CA 90038-2595 | 2020-07-13 |
| 1306464979 | Aleracare Medical Group of California | Clinic/Center | 4849 Van Nuys Blvd Ste 220, Sherman Oaks, CA 91403-2155 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
| City | SUSANVILLE |
| Zip Code | 96130 |
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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.