BANNER PHYSICIAN SPECIALISTS ARIZONA LLC (NPI# 1801160569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801160569 |
| Entity Type | Organization |
| Organization Name | BANNER PHYSICIAN SPECIALISTS ARIZONA LLC |
| Practice Address |
9305 W Thomas Rd Ste 405 Phoenix AZ 85037-3328 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 6233277900 |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2012-03-01 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366799355 | Banner Physician Specialists Arizona LLC | Clinic/Center | 601 N Navajo, Page, AZ 86040 | 2012-08-08 |
| 1033730429 | Banner Physician Specialists Arizona LLC | Clinic/Center | 501 N Navajo Dr, Page, AZ 86040-0959 | 2020-04-27 |
| 1750929949 | Banner Physician Specialists Arizona LLC | Clinic/Center | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2019-12-18 |
| 1821368218 | Banner Physician Specialists Arizona LLC | Clinic/Center | 10150 N 67th Ave, Ste 101, Glendale, AZ 85302-1004 | 2012-01-03 |
| 1275802829 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 13760 N 93rd Ave, Peoria, AZ 85381-4201 | 2011-12-27 |
| 1679842223 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 14420 W Meeker Blvd, Ste 104, Sun City West, AZ 85375-5286 | 2011-12-27 |
| 1588933139 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 9165 W Thunderbird Rd, Peoria, AZ 85381-4847 | 2011-12-27 |
| 1548538069 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 14416 W Meeker Blvd, Sun City West, AZ 85375-5284 | 2011-12-12 |
| 1992073498 | Banner Physician Specialists Arizona LLC | Durable Medical Equipment & Medical Supplies | 13640 N Plaza Del Rio Blvd, Ste 120, Peoria, AZ 85381-4846 | 2011-12-12 |
| 1316228802 | Banner Physician Specialists Arizona LLC | Clinic/Center | 37100 N Gantzel Rd, Ste 107, San Tan Valley, AZ 85140-7349 | 2011-08-29 |
| Street Address |
9305 W THOMAS RD STE 405 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85037-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467457747 | Mystie L Johnson | Obstetrics & Gynecology | 9305 W Thomas Rd, Ste 155, Phoenix, AZ 85037-3328 | 2005-06-14 |
| 1295219624 | Samantha Albrecht | Nurse Practitioner | 9305 W Thomas Rd, Phoenix, AZ 85037-3328 | 2018-09-21 |
| 1225570732 | Omni Dermatology Estrella LLC | Specialist | 9305 W Thomas Rd, Ste 350, Phoenix, AZ 85037-3328 | 2016-11-15 |
| 1326597444 | Vanessa Breguez Mitchell | Physician Assistant | 9305 W Thomas Rd, Suite 410, Phoenix, AZ 85037-3328 | 2016-09-30 |
| 1912353806 | Center for Orthopedic Research and Education, Inc | Durable Medical Equipment & Medical Supplies | 9305 W Thomas Rd, Suite 275, Phoenix, AZ 85037-3328 | 2016-05-10 |
| 1700270071 | Sarah Francis Debenedetto | Physical Therapist | 9305 W Thomas Rd, Suite 150, Phoenix, AZ 85037-3328 | 2015-03-25 |
| 1881088144 | Keith Butler | Physical Therapist | 9305 W Thomas Rd, Suite 150, Phoenix, AZ 85037-3328 | 2015-03-25 |
| 1366848814 | Tanner Jo Caughey | Physical Therapist | 9305 W Thomas Rd, Suite 150, Phoenix, AZ 85037-3328 | 2014-11-11 |
| 1720403397 | Caroline Seronde | Physical Therapy Assistant | 9305 W Thomas Rd, Ste 150, Phoenix, AZ 85037-3328 | 2014-02-19 |
| 1750702759 | Holly Hussey | Occupational Therapist | 9305 W Thomas Rd, Suite 150, Phoenix, AZ 85037-3328 | 2013-12-18 |
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| 1578025136 | Jennifer Natasha Kunz | Nurse Practitioner | Cleanslate, 8410 W. Thomas Rd, Phoenix, AZ 85037 | 2019-04-03 |
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| 1417442799 | Prop Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9250 W Thomas Rd Ste 220, Phoenix, AZ 85037 | 2018-06-28 |
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| 1063953081 | Karla Soward | Radiologic Technologist | 2015 N Rascon Loop, Phoenix, AZ 85037 | 2017-03-09 |
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| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
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|---|---|---|---|---|
| 1760080238 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3807 N 7th St Ste P, Phoenix, AZ 85014-5005 | 2020-10-15 |
| 1528675469 | Antelope Works, LLC | Durable Medical Equipment & Medical Supplies | 2601 N 3rd St Ste 200, Phoenix, AZ 85004-1145 | 2020-09-24 |
| 1821607060 | Am Apnea and Tmj LLC | Durable Medical Equipment & Medical Supplies | 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 | 2020-07-23 |
| 1013536630 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 10844 N 23rd Ave Ste P125, Phoenix, AZ 85029-4924 | 2020-04-14 |
| 1376162073 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 4136 North 75th Ave, Suite 116, Room P, Phoenix, AZ 85033 | 2020-04-13 |
| 1689293367 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1515 E Osborn Rd Ste P1, Phoenix, AZ 85014-5309 | 2020-04-13 |
| 1619596319 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1840 N 95th Ave Ste 132p, Phoenix, AZ 85037-4445 | 2020-04-13 |
| 1326688573 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3227 E Bell Road, Suite 170, Room P1, Phoenix, AZ 85032 | 2020-01-15 |
| 1659915908 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2311 W Royal Palm Rd Ste P, Phoenix, AZ 85021-4916 | 2019-10-30 |
| 1255972295 | Arizona Dental Health Partners LLC | Durable Medical Equipment & Medical Supplies | 3134 W Carefree Hwy Ste 9, Phoenix, AZ 85086-4001 | 2019-10-01 |
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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.