BANNER CANCER CENTER SPECIALISTS LLC (NPI# 1518253152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518253152 |
| Entity Type | Organization |
| Organization Name | BANNER CANCER CENTER SPECIALISTS LLC |
| Practice Address |
2946 E Banner Gateway Drive Gilbert AZ 85234 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 4802566444 |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-10-19 |
| Authorized Official Name | DENNIS E DAHLEN (SR VP FINANCE) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0200X |
Clinic/Center Specialization: Oncology |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588158448 | Banner Cancer Center Specialists LLC | Clinic/Center | 122 E Main St, Payson, AZ 85541-5574 | 2018-06-14 |
| Street Address |
2946 E BANNER GATEWAY DRIVE |
| City | GILBERT |
| State | AZ |
| Zip Code | 85234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386685915 | Sandra Gail Kline | Nurse Practitioner | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2006-06-08 |
| 1114558491 | Colby Rhel Horton | Physician Assistant | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2020-01-27 |
| 1518458694 | Sharon Martin | Nurse Practitioner | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2018-05-23 |
| 1801324223 | Danielle Rae Fischer | Physician Assistant | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2017-05-30 |
| 1902284599 | Robert Michael Ellis | Nurse Practitioner | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2015-05-14 |
| 1104103555 | Banner Gateway Medical Center | Durable Medical Equipment & Medical Supplies | 2946 E Banner Gateway Drive, Rm 2008, Gilbert, AZ 85234 | 2011-11-14 |
| 1285943654 | Katrina Armida Cardenas Gaines | Physician Assistant | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2010-10-01 |
| 1750390456 | Mark Brenner | Urology | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500962 | Fatima Health LLC | Nurse Practitioner | 760 North Swallow Lane, Gilbert, AZ 85234 | 2020-05-22 |
| 1073152070 | American Care Concepts Hospice LLC | Hospice Care, Community Based | 765 N. Lindsay Rd., Ste. 208, Gilbert, AZ 85234 | 2019-12-23 |
| 1457918864 | Intuitive Healing Counseling Services, Pllc | Counselor | 3303 E Baseline Rd, Building 5, Suite 109, Gilbert, AZ 85234 | 2019-05-21 |
| 1487123907 | San Tan Behavioral Health Services LLC | Respite Care | 2671 East Vermont Court, Gilbert, AZ 85234 | 2018-11-14 |
| 1770052292 | San Tan Behavioral Health Services | Respite Care | 3970 East Juanita Avenue, Gilbert, AZ 85234 | 2018-11-14 |
| 1891262887 | Victoria Elizabeth Klennertt | Behavior Technician | 3503 E Michelle Way, Gilbert, AZ 85234 | 2018-10-27 |
| 1225503634 | Julia Elizabeth Wiens | Social Worker | 3651 E Baseline Rd Ste 120, Gilbert, AZ 85234 | 2018-10-11 |
| 1295219798 | Raylene Dawn Cargiulo | Registered Nurse | 55 S. Greenfield Rd., Gilbert, AZ 85234 | 2018-09-20 |
| 1346729092 | Katherine M Winegar | Nurse Practitioner | Banner Md Anderson Cancer Center- Administration Office, 2940 E Banner Gateway Drive, Gilbert, AZ 85234 | 2018-08-13 |
| 1881189199 | Desert Valley Oral Surgery | Oral & Maxillofacial Surgery | 2915 E. Baseline Road, Suite 106, Gilbert, AZ 85234 | 2018-06-28 |
| Find all providers in zip 85234 | ||||
| Taxonomy Code | 261QX0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073007787 | Southwest Cancer Care LLC | Clinic/Center | 100 E 5th St, Douglas, AZ 85607-2859 | 2018-06-15 |
| 1588158448 | Banner Cancer Center Specialists LLC | Clinic/Center | 122 E Main St, Payson, AZ 85541-5574 | 2018-06-14 |
| 1235656174 | Vincere Surgery Center LLC | Clinic/Center | 7469 E Monte Cristo Ave, Scottsdale, AZ 85260-1618 | 2017-08-22 |
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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.