BANNER HEALTH (NPI# 1396156139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396156139 |
| Entity Type | Organization |
| Organization Name | BANNER HEALTH |
| Other Organization Name | BANNER HEALTH CENTER PEORIA |
| Practice Address |
13640 N Plaza Del Rio Blvd 3rd Floor, Suite 350 Peoria AZ 85381-4846 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 6235835044 |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-05-14 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 16098 | AZ | Suppliers |
| Other Name | Type Code |
|---|---|
| Banner Health Center Peoria | Doing Business As Name - 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 |
| 1205267549 | Banner Health | Clinic/Center | 1345 A Paul Bunyan Rd, Susanville, CA 96130-3159 | 2013-12-12 |
| 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 |
| 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 |
13640 N PLAZA DEL RIO BLVD 3RD FLOOR, SUITE 350 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649279654 | John Peter Kieley | Internal Medicine | 13640 N Plaza Del Rio Blvd, Suite 220, Peoria, AZ 85381-4846 | 2005-07-20 |
| 1366913618 | Krishna Keshav | Nurse Practitioner | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381 | 2018-12-16 |
| 1871062158 | Samantha Mae Boartfield | Pharmacist | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2018-11-16 |
| 1790236487 | Israa Al-sayyed | Physician Assistant | 13640 N Plaza Del Rio Blvd, Ste 340, Peoria, AZ 85381-4846 | 2016-10-18 |
| 1326408444 | Banner Pharmacy Services LLC | Pharmacy | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2016-03-02 |
| 1801278981 | Shin Jung Yoon | Family Medicine | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381 | 2015-06-24 |
| 1831584044 | Michelle Obillo Prestoza | Family Medicine | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2015-04-03 |
| 1578967162 | Tina Marino | Nurse Practitioner | 13640 N Plaza Del Rio Blvd, Suite 230, Peoria, AZ 85381-4846 | 2014-10-10 |
| 1932522836 | Deborah L. Burns | Registered Nurse | 13640 N Plaza Del Rio Blvd, 210, Peoria, AZ 85381-4846 | 2014-01-28 |
| 1700207750 | Sonora Quest Laboratories, LLC | Clinical Medical Laboratory | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2013-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124585534 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 5209 W. War Memorial Drive, Grand Prairie Mall, Peoria, IL 61615-9250 | 2019-02-22 |
| 1770125387 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 5901 N Prospect Rd, Peoria, IL 61614-4358 | 2019-10-15 |
| 1063986511 | Zjrd, LLC | Non-Pharmacy Dispensing Site | 13090 N 94th Dr Ste 212, Peoria, AZ 85381-4258 | 2019-01-17 |
| 1982170734 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 10408 N Centerway Dr Ste Cde, Peoria, IL 61615-1234 | 2018-10-19 |
| 1194138545 | The Pain Center of Arizona, PC | Non-Pharmacy Dispensing Site | 9401 W Thunderbird Rd, Suite 180, Peoria, AZ 85381-4233 | 2014-06-03 |
| 1932442928 | Afc of Peoria, Pllc | Non-Pharmacy Dispensing Site | 15256 N 75th Ave, Suite 360, Peoria, AZ 85381-4760 | 2013-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609375740 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 89 Civic Center Ln, Lake Havasu City, AZ 86403-0810 | 2018-02-05 |
| 1518318328 | John C Lincoln, LLC | Non-Pharmacy Dispensing Site | 6220 W Bell Rd, Suite 100, Glendale, AZ 85308-3718 | 2016-06-23 |
| 1992178982 | Caremore Health Plan of Arizona Inc | Non-Pharmacy Dispensing Site | 315 W Irvington Rd, Ste.101, Tucson, AZ 85714-3151 | 2015-11-12 |
| 1558747725 | Arizona Oncology Associates, PC | Non-Pharmacy Dispensing Site | 3188 N Windsong Dr # Sr, Ste. # A, Prescott Valley, AZ 86314-1220 | 2015-08-10 |
| 1578976379 | Arizona Oncology Associates PC | Non-Pharmacy Dispensing Site | 1315 S La Canada Dr, Green Valley, AZ 85622-1915 | 2014-06-09 |
| 1023302643 | Tri-state Medical Specialists LLC | Non-Pharmacy Dispensing Site | 1510 Wagon Wheel Lane, Suite 110, Fort Mohave, AZ 86426-6698 | 2011-05-31 |
| 1396066395 | Wound Care Usa, LLC | Non-Pharmacy Dispensing Site | 3959 E Speedway Blvd, Suite 316, Tucson, AZ 85712-4553 | 2010-06-14 |
| 1417112541 | Gold Canyon Internal Medicine | Non-Pharmacy Dispensing Site | 6724 S Kings Ranch Rd Ste 102, Gold Canyon, AZ 85118-2963 | 2008-07-29 |
| 1740442573 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 10210 N. 92nd St, Suite 301, Scottsdale, AZ 85258 | 2008-07-02 |
| 1558523381 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 18700 N. 64th Dr, Suite 101, Glendale, AZ 85308 | 2008-07-02 |
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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.