BANNER OCCUPATIONAL HEALTH ARIZONA LLC (NPI# 1477196277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477196277 |
| Entity Type | Organization |
| Organization Name | BANNER OCCUPATIONAL HEALTH ARIZONA LLC |
| Practice Address |
2225 W Southern Ave Mesa AZ 85202-4716 |
| Mailing Address |
2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 |
| Practice Telephone | 4804126374 |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2019-10-24 |
| Authorized Official Name | DENNIS LARAWAY (CFO) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699318105 | Banner Occupational Health Arizona LLC | Clinic/Center | 1300 N 12th St Ste 250, Phoenix, AZ 85006-2848 | 2019-10-28 |
| 1669015467 | Banner Occupational Health Arizona LLC | Clinic/Center | 1920 N Higley Rd Ste 108, Gilbert, AZ 85234-1626 | 2019-10-24 |
| 1649813445 | Banner Occupational Health Arizona LLC | Clinic/Center | 5601 W Eugie Ave Ste 213, Glendale, AZ 85304-1258 | 2019-10-24 |
| 1750924551 | Banner Occupational Health Arizona LLC | Clinic/Center | 1676 E Mcmurray Blvd Ste 2, Casa Grande, AZ 85122-4798 | 2019-10-24 |
| 1144572611 | Banner Occupational Health Arizona LLC | Clinic/Center | 1300 N 12th St Ste 520, Phoenix, AZ 85006-2849 | 2012-10-09 |
| 1194368993 | Banner Occupational Health Arizona LLC | Clinic/Center | 1979 W Ray Rd, Chandler, AZ 85224-4007 | 2019-10-24 |
| 1811530611 | Banner Occupational Health Arizona LLC | Clinic/Center | 9305 W Thomas Rd Ste 235, Phoenix, AZ 85037-3363 | 2019-10-24 |
| 1679116479 | Banner Occupational Health Arizona LLC | Clinic/Center | 1101 N Wilmot Rd Ste 101, Tucson, AZ 85712-5144 | 2019-10-24 |
| Street Address |
2225 W SOUTHERN AVE |
| City | MESA |
| State | AZ |
| Zip Code | 85202-4716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235195470 | Sheila J Zollicoffer-manley | Nurse Practitioner | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2006-04-25 |
| 1518511674 | Tatyn Moen | Speech-Language Pathologist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2019-07-27 |
| 1689175747 | Kimberly Hubbard | Physical Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-02-23 |
| 1679073878 | Maria Camacho | Speech-Language Pathologist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-02-15 |
| 1871093070 | Mary Martha Stefan | Occupational Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-02-15 |
| 1295233245 | Camille Lambert | Physical Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-01-24 |
| 1780192906 | Sara Becker | Physical Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2018-01-22 |
| 1497130454 | Ariel Danielle Demoret | Speech-Language Pathologist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2015-07-20 |
| 1831510130 | Brenna Callaway | Speech-Language Pathologist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2014-01-04 |
| 1619243177 | Sarah M King | Occupational Therapist | 2225 W Southern Ave, Mesa, AZ 85202-4716 | 2012-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275173536 | Samuel A Wolde | Counselor | Clear View Counseling, 2651 W Guadalupe Rd, Mesa, AZ 85202 | 2020-01-14 |
| 1912549171 | Lauren Barbara Loges | Occupational Therapist | 2225 E. Southern Avenue, Mesa, AZ 85202 | 2019-10-09 |
| 1245724822 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1450 S Dobson Rd Ste B326, Mesa, AZ 85202 | 2018-06-18 |
| 1457843310 | Jay Douglas Baumgardner | Physical Therapist | 1941 W. Guadalupe Rd. Suite 109, Mesa, AZ 85202 | 2018-06-05 |
| 1144746215 | Alyson Fix | Physician Assistant | 1432 S Dobson Rd Ste 304, Mesa, AZ 85202 | 2017-08-20 |
| 1194108852 | Robert Dale Labrum | Counselor | 1255 W Baseline Rd Ste B-258, Mesa, AZ 85202 | 2015-06-30 |
| 1114325677 | John David Shull Jr. | Physician Assistant | 1520 S Dobson Rd Ste 305, Mesa, AZ 85202 | 2014-12-16 |
| 1316356207 | Embry Womens Health LLC | Nurse Practitioner | 2204 S Dobson Road, Suite 203, Mesa, AZ 85202 | 2014-08-05 |
| 1619312899 | Fiza Naueed Khan | Internal Medicine | 1400 South Dobson Road, Attn: Bmg Hospitalists Team/amanda Gump, Mesa, AZ 85202 | 2013-05-01 |
| 1487903373 | Jodi Lynn Mealer | Pharmacist | 1951 W. Baseline Rd., Mesa, AZ 85202 | 2012-09-06 |
| Find all providers in zip 85202 | ||||
| Taxonomy Code | 261QX0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Occupational Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134473416 | Ccfx,llc | Clinic/Center | 2622 E Javelina Cir, Mesa, AZ 85204-7127 | 2012-11-07 |
| 1497298178 | Arizona Occupational Medical Clinics | Clinic/Center | 4540 E Baseline Rd Ste 105, Mesa, AZ 85206-4616 | 2016-11-29 |
| 1174951685 | Occupational Heatlh Centers of The Southwest Pa | Clinic/Center | 1959 S Val Vista Dr, Suite 106, Mesa, AZ 85204-7356 | 2013-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699318105 | Banner Occupational Health Arizona LLC | Clinic/Center | 1300 N 12th St Ste 250, Phoenix, AZ 85006-2848 | 2019-10-28 |
| 1669015467 | Banner Occupational Health Arizona LLC | Clinic/Center | 1920 N Higley Rd Ste 108, Gilbert, AZ 85234-1626 | 2019-10-24 |
| 1649813445 | Banner Occupational Health Arizona LLC | Clinic/Center | 5601 W Eugie Ave Ste 213, Glendale, AZ 85304-1258 | 2019-10-24 |
| 1750924551 | Banner Occupational Health Arizona LLC | Clinic/Center | 1676 E Mcmurray Blvd Ste 2, Casa Grande, AZ 85122-4798 | 2019-10-24 |
| 1407412331 | Banner Occupational Health - Onsite, LLC | Clinic/Center | 1621 W Rio Salado Pkwy Bldg D, Tempe, AZ 85281-2608 | 2019-05-16 |
| 1578126769 | Watch Me Grow, LLC | Clinic/Center | 6602 S Constellation Way, Gilbert, AZ 85298-5700 | 2019-04-15 |
| 1982145892 | Michelle Toyos | Clinic/Center | 8953 E Kirkpatrick Cir, Tucson, AZ 85710-4447 | 2017-03-10 |
| 1578974960 | Body 4 Life | Clinic/Center | 8300 N Hayden Rd Ste A-203, Scottsdale, AZ 85258-2481 | 2014-05-19 |
| 1205173150 | Lurea Inman | Clinic/Center | 18610 E Raven Dr, Queen Creek, AZ 85142-5542 | 2013-01-12 |
| 1144572611 | Banner Occupational Health Arizona LLC | Clinic/Center | 1300 N 12th St Ste 520, Phoenix, AZ 85006-2849 | 2012-10-09 |
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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.