BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS LIVER DISEASE SERVI (NPI# 1346558962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346558962 |
| Entity Type | Organization |
| Organization Name | BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS LIVER DISEASE SERVI |
| Practice Address |
77 W Forest Ave Suite 210 Flagstaff AZ 86001-1479 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 6028394123 |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2015-02-26 |
| Authorized Official Name | DENNIS E 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306154943 | Banner -- University Medical Center Phoenix Campus Liver Disease Servi | Clinic/Center | 2771 Silver Creek Rd, Suite 101, Bullhead City, AZ 86442-7959 | 2010-09-16 |
| 1851613897 | Banner -- University Medical Center Phoenix Campus Liver Disease Servi | Clinic/Center | 1521 E Tangerine Rd, Oro Valley, AZ 85755-6225 | 2010-02-18 |
| Street Address |
77 W FOREST AVE SUITE 210 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235133059 | Gretchen Karr Schaber | Nurse Practitioner | 77 W Forest Ave, Ste 302, Flagstaff, AZ 86001-1481 | 2005-06-09 |
| 1740728088 | Susan Dale Wall | Social Worker | 77 W Forest Ave, Suite 202, Flagstaff, AZ 86001-1479 | 2017-02-07 |
| 1326408527 | Taye Nelson | Nurse Practitioner | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2016-03-01 |
| 1639564453 | Mary Elizabeth Smith Iles | Pediatrics | 77 W Forest Ave, Flagstaff, AZ 86001 | 2015-03-30 |
| 1174914915 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2015-02-16 |
| 1699182188 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2014-07-16 |
| 1033538533 | Neina Orrillo | Registered Nurse | 77 W Forest Ave, Suite 207, Flagstaff, AZ 86001 | 2014-04-11 |
| 1720424997 | Meredith Katz Sena | Specialist | 77 W Forest Ave, Ste 301, Flagstaff, AZ 86001-1479 | 2013-05-15 |
| 1669815825 | Lauren Diane Hayward | Pediatrics | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2013-04-08 |
| 1548510019 | Mark Daniel Noorlander | Nurse Anesthetist, Certified Registered | 77 W Forest Ave, Suite 207, Flagstaff, AZ 86001-1479 | 2012-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073583472 | North Country Healthcare, Inc. | Clinic/Center | 2920 N. 4th Street, Flagstaff, AZ 86004 | 2006-01-26 |
| 1871109009 | Vasco Healthcare Inc | Clinic/Center | 1501 S Yale St Ste 152, Flagstaff, AZ 86001-7337 | 2020-09-22 |
| 1578930012 | Vera Whole Health Inc | Clinic/Center | 1500 E Cedar Ave, Suites 80, Flagstaff, AZ 86004-1641 | 2015-09-01 |
| 1821228826 | North Country Healthcare Inc. | Clinic/Center | 2187 N Vickey St Ste 2, Flagstaff, AZ 86004-6121 | 2009-07-24 |
| 1053587261 | North Country Healthcare Inc | Clinic/Center | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2008-05-07 |
| 1164495503 | Northern Arizona Orthopaedics, Ltd. | Clinic/Center | 1485 N Turquoise Dr, Suite 200, Flagstaff, AZ 86001-1398 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254918 | Assyrian Family Health Alliance | Clinic/Center | 10210 N 32nd St Ste C6, Phoenix, AZ 85028-3826 | 2020-10-26 |
| 1659970242 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33300 N 32nd Ave, Phoenix, AZ 85085-8877 | 2020-10-23 |
| 1689273542 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33400 N 32nd Ave Fl 1, Phoenix, AZ 85085-8876 | 2020-10-21 |
| 1629676317 | Bethel Hills Integrated Healthcare | Clinic/Center | 13838 S 46th Pl Ste 300, Phoenix, AZ 85044-7804 | 2020-10-14 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| 1235745464 | Vasco Healthcare Inc | Clinic/Center | 2110 W 24th St Ste A, Yuma, AZ 85364-8878 | 2020-09-22 |
| 1265048490 | Vasco Healthcare Inc | Clinic/Center | 8952 E Desert Cove Ave Ste 204, Scottsdale, AZ 85260-6777 | 2020-09-22 |
| 1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
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Please comment or provide details below to improve the information on BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS LIVER DISEASE SERVI.
| 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.