BANNER MEDICAL GROUP GREELEY LLC (NPI# 1386817880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386817880 |
| Entity Type | Organization |
| Organization Name | BANNER MEDICAL GROUP GREELEY LLC |
| Practice Address |
222 Johnstown Center Dr Johnstown CO 80534-9030 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 9705874974 |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-12-16 |
| 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 |
|---|---|---|---|
| CO | 05725046 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972804318 | Banner Medical Group Greeley LLC | Clinic/Center | 2010 16th St, Greeley, CO 80631-5162 | 2010-11-16 |
| 1992018113 | Banner Medical Group Greeley LLC | Clinic/Center | 2001 70th Ave, Suite 110, Greeley, CO 80634-4621 | 2010-07-16 |
| 1679804223 | Banner Medical Group Greeley LLC | Clinic/Center | 1300 Main St, Windsor, CO 80550-5989 | 2010-01-21 |
| 1104070333 | Banner Medical Group Greeley LLC | Clinic/Center | 5623 W 19th St, Greeley, CO 80634-2901 | 2008-11-14 |
| 1841441870 | Banner Medical Group Greeley LLC | Clinic/Center | 100 S Cherry Ave, Unit 1, Eaton, CO 80615-8255 | 2008-10-08 |
| Street Address |
222 JOHNSTOWN CENTER DR |
| City | JOHNSTOWN |
| State | CO |
| Zip Code | 80534-9030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467412650 | Thomas A Kenigsberg | Family Medicine | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2006-03-23 |
| 1558871442 | Kelsey Figg Fifield | Physical Therapist | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2017-10-04 |
| 1285173229 | Victoria Flood | Physical Therapist | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2017-02-22 |
| 1629513767 | Krista Lee Plate | Nurse Practitioner | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2016-12-28 |
| 1033470737 | Banner Health Physicians Colorado LLC | Clinic/Center | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2012-05-30 |
| 1366601700 | Courtney Beth Isley | Family Medicine | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2008-06-02 |
| 1619905296 | Johnstown Family Physicians | Clinic/Center | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2006-06-30 |
| 1033179981 | Joseph Edwin Gregory | Family Medicine | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790299410 | Bauer Occupational Therapy, LLC | Occupational Therapist | 442 La Costa Ln, Johnstown, CO 80534 | 2017-11-17 |
| 1942698071 | Family Physicians of Greeley, LLP | Family Medicine | 473 Castle Pines Ave, Suite 1, Johnstown, CO 80534 | 2014-12-23 |
| 1376761924 | Steven L Martin | Dentist | 5 N. Parish Ave., Johnstown, CO 80534 | 2007-04-20 |
| 1699896613 | Ashlea Elizabeth Franques | Pediatrics | 4435 Ronald Reagan Blvd, Johnstown, CO 80534 | 2007-04-03 |
| 1720069198 | Kenneth A Pettine | Orthopaedic Surgery | 4795 Larimer Parkway, Johnstown, CO 80534 | 2005-11-10 |
| 1043858251 | Kristen Mcfarland | Physical Therapist | 247 Mountain Avenue, Berthoud, CO 80534 | 2019-12-18 |
| 1841780400 | Colorado Rehabilitation Associates LLC | Physical Medicine & Rehabilitation | 4401 Union St, Johnstown, CO 80534 | 2018-05-18 |
| 1073059523 | Santibanez Aguirre PC | Hospitalist | 4401a Union Street, Johnstown, CO 80534 | 2017-01-09 |
| 1811142524 | 25/34 Plastic Surgery Associates, PC | Specialist | 4450 Union St., Suite 100, Johnstown, CO 80534-0001 | 2008-11-21 |
| 1790794824 | Marc Anthony Masotti | Internal Medicine | 4401a Union St, Johnstown, CO 80534-2800 | 2006-08-07 |
| Find all providers in zip 80534 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427467638 | Advanced Care Hospital of Northern Colorado LLC | Clinic/Center | 4401a Union St, Johnstown, CO 80534-2800 | 2014-08-13 |
| 1033470737 | Banner Health Physicians Colorado LLC | Clinic/Center | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2012-05-30 |
| 1356480982 | Adamson Medical Corporation PC | Clinic/Center | 4401 Union St, Johnstown, CO 80534-2800 | 2007-02-06 |
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| 1669008314 | Dr. Sunda Friedman Tebockhorst Psychologicl Services, Ltd | Clinic/Center | 588 N Hwy 287, Suite 200, Lafayette, CO 80026 | 2020-03-13 |
| 1609400407 | Pure Healthcare of Colorado LLC | Clinic/Center | 320 E Fontanero St Ste 103, Colorado Springs, CO 80907-7535 | 2020-03-02 |
| 1073146833 | Boulder Medical Center, P.C. | Clinic/Center | 89 S Briggs St Ste 105, Erie, CO 80516-4063 | 2020-02-19 |
| Find all providers with the same taxonomy | ||||
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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.