BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC (NPI# 1649544362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649544362 |
| Entity Type | Organization |
| Organization Name | BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC |
| Practice Address |
13640 N Plaza Del Rio Blvd Ste 102 Peoria AZ 85381-4846 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 6238763928 |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2012-02-27 |
| 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 | 291U00000X | Clinical Medical Laboratory | Laboratories |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194164681 | Banner Primary Care Physicians Arizona LLC | Durable Medical Equipment & Medical Supplies | 9780 S Estrella Pkwy, Goodyear, AZ 85338-7114 | 2013-06-18 |
| 1790306066 | Banner Primary Care Physicians Arizona LLC | Clinic/Center | 501 N Navajo Dr, Page, AZ 86040-0959 | 2020-04-28 |
| 1124467600 | Banner Primary Care Physicians Arizona LLC | Durable Medical Equipment & Medical Supplies | 20751 W Market St, Buckeye, AZ 85396-7893 | 2013-06-18 |
| 1750630836 | Banner Primary Care Physicians Arizona LLC | Durable Medical Equipment & Medical Supplies | 14416 W Meeker Blvd Ste 100, Sun City West, AZ 85375 | 2012-09-05 |
| 1710234703 | Banner Primary Care Physicians Arizona LLC | Clinic/Center | 601 N Navajo, Page, AZ 86040 | 2012-08-08 |
| 1659640902 | Banner Primary Care Physicians Arizona LLC | Clinic/Center | 2474 E Hunt Hwy, Suite 10, San Tan Valley, AZ 85143-5210 | 2011-12-15 |
| 1093083503 | Banner Primary Care Physicians Arizona LLC | Durable Medical Equipment & Medical Supplies | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2011-12-12 |
| 1417238908 | Banner Primary Care Physicians Arizona LLC | Clinic/Center | 3336 E Chandler Heights Rd, Ste A-101, Gilbert, AZ 85298-4259 | 2011-08-29 |
| Street Address |
13640 N PLAZA DEL RIO BLVD STE 102 |
| 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 |
| 1396156139 | Banner Health | Non-Pharmacy Dispensing Site | 13640 N Plaza Del Rio Blvd, 3rd Floor, Suite 350, Peoria, AZ 85381-4846 | 2014-05-14 |
| 1932522836 | Deborah L. Burns | Registered Nurse | 13640 N Plaza Del Rio Blvd, 210, Peoria, AZ 85381-4846 | 2014-01-28 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861589376 | Sonora Quest Laboratories, LLC | Clinical Medical Laboratory | 13760 N 93rd Ave Ste 107, Peoria, AZ 85381-4260 | 2006-10-06 |
| 1700207750 | Sonora Quest Laboratories, LLC | Clinical Medical Laboratory | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2013-12-18 |
| 1497998017 | Touchstone Imaging of Peoria, LLC | Clinical Medical Laboratory | 6708 N Knoxville Ave, Suite 2, Peoria, IL 61614-2862 | 2009-04-13 |
| 1932310026 | Saint Francis Medical Center | Clinical Medical Laboratory | 530 Ne Glen Oak Ave, Peoria, IL 61603-3133 | 2007-05-24 |
| 1871610030 | Lakeview Lab | Clinical Medical Laboratory | 13090 N 94th Dr, Peoria, AZ 85381-4256 | 2007-03-23 |
| 1245361773 | Banner Arizona Medical Clinic Ltd | Clinical Medical Laboratory | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2007-03-08 |
| 1497785547 | Arizona Medical Clinic, Ltd. | Clinical Medical Laboratory | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2006-07-04 |
| 1194711234 | Comprehensive Hemostasis and Thrombosis Institute | Clinical Medical Laboratory | 4727 N Sheridan Rd, Peoria, IL 61614-5925 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261804 | Cov19 Plus Testing Laboratory | Clinical Medical Laboratory | 793 N Alma School Rd # D1, Chandler, AZ 85224-3681 | 2020-10-09 |
| 1760089080 | Cov10 Plus Testing Laboratory | Clinical Medical Laboratory | 590 N Alma School Rd Ste 7, Chandler, AZ 85224-4382 | 2020-10-09 |
| 1841807492 | Prn Diagnostics LLC | Clinical Medical Laboratory | 7007 E Main St, Mesa, AZ 85207-8204 | 2020-09-28 |
| 1841803939 | Sochilt Brown | Clinical Medical Laboratory | 41810 N Venture Dr Ste 152, Anthem, AZ 85086-3169 | 2020-08-28 |
| 1043821051 | Spectacular Med LLC | Clinical Medical Laboratory | 9989 N 95th St, Scottsdale, AZ 85258-4596 | 2020-08-12 |
| 1336757780 | Saguaro Health & Security LLC | Clinical Medical Laboratory | 4165 N Craftsman Ct Ste A, Scottsdale, AZ 85251-3863 | 2020-07-21 |
| 1346868452 | Covid Laboratories LLC | Clinical Medical Laboratory | 17727 N 92nd Way, Scottsdale, AZ 85255-6025 | 2020-07-06 |
| 1649890807 | Promed Services LLC | Clinical Medical Laboratory | 6986 E Mary Dr, Tucson, AZ 85730-1713 | 2020-04-17 |
| 1780203638 | Translational Genomics Research Institute | Clinical Medical Laboratory | 3051 W Shamrell Blvd Ste 106, Flagstaff, AZ 86005-9435 | 2020-04-10 |
| 1710512389 | Path Analytics Laboratory LLC | Clinical Medical Laboratory | 13402 N Scottsdale Rd Ste B195, Scottsdale, AZ 85254-4066 | 2020-03-04 |
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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.