BANNER ARIZONA MEDICAL CLINIC LTD (NPI# 1750347936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750347936 |
| Entity Type | Organization |
| Organization Name | BANNER ARIZONA MEDICAL CLINIC LTD |
| Practice Address |
13640 N Plaza Del Rio Blvd Peoria AZ 85381-4846 |
| Practice Telephone | 6238763800 |
| Practice Fax Number | 6239729590 |
| Mailing Telephone | 6238763800 |
| Mailing Fax Number | 6239729590 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2008-12-03 |
| 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 |
OTC3936 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 0516437 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780715698 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 9165 W Thunderbird Road, Peoria, AZ 85381 | 2007-03-09 |
| 1952432866 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 14416 W Meeker Blvd, Sun City West, AZ 85375-5284 | 2007-03-09 |
| 1225169188 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 14420 W Meeker Blvd, Sun City West, AZ 85375-5286 | 2007-03-09 |
| 1578694055 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2007-03-08 |
| 1245361773 | Banner Arizona Medical Clinic Ltd | Clinical Medical Laboratory | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2007-03-08 |
| 1447381207 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 14418 W Meeker Blvd, Sun City West, AZ 85375-5283 | 2007-03-07 |
| 1568593325 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 10401 W Thunderbird Blvd, Ste 209, Sun City, AZ 85351-3004 | 2007-03-07 |
| 1487785002 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 13760 N 93rd Ave, Peoria, AZ 85381-4201 | 2007-03-07 |
| Street Address |
13640 N PLAZA DEL RIO BLVD |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841806064 | Vasco Healthcare Inc | Clinic/Center | 7615 W Thunderbird Rd Ste 106, Peoria, AZ 85381-6083 | 2020-09-22 |
| 1750929949 | Banner Physician Specialists Arizona LLC | Clinic/Center | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2019-12-18 |
| 1154822369 | Regenerative Foot & Ankle LLC | Clinic/Center | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-02-22 |
| 1811220650 | Musculoskeletal Surgery Center, LLC | Clinic/Center | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2009-09-11 |
| 1992829485 | Cardinal Medical Group, Ltd. | Clinic/Center | 6339 N Big Hollow Rd, Peoria, IL 61615-2907 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254918 | Assyrian Family Health Alliance | Clinic/Center | 10210 N 32nd St Ste C6, Phoenix, AZ 85028-3826 | 2020-10-26 |
| 1659970242 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33300 N 32nd Ave, Phoenix, AZ 85085-8877 | 2020-10-23 |
| 1689273542 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33400 N 32nd Ave Fl 1, Phoenix, AZ 85085-8876 | 2020-10-21 |
| 1629676317 | Bethel Hills Integrated Healthcare | Clinic/Center | 13838 S 46th Pl Ste 300, Phoenix, AZ 85044-7804 | 2020-10-14 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| 1235745464 | Vasco Healthcare Inc | Clinic/Center | 2110 W 24th St Ste A, Yuma, AZ 85364-8878 | 2020-09-22 |
| 1265048490 | Vasco Healthcare Inc | Clinic/Center | 8952 E Desert Cove Ave Ste 204, Scottsdale, AZ 85260-6777 | 2020-09-22 |
| 1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
| 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.