BANNER HEALTH PHYSICIANS WEST LLC (NPI# 1881950541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881950541 |
| Entity Type | Organization |
| Organization Name | BANNER HEALTH PHYSICIANS WEST LLC |
| Practice Address |
1800 Spring Ridge Dr Susanville CA 96130-6100 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 5302522225 |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-11-12 |
| 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 | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073516 | Banner Health Physicians West LLC | Clinic/Center | 201 14th St Ste B100, Wheatland, WY 82201-3201 | 2020-11-06 |
| 1528678786 | Banner Health Physicians West LLC | Clinic/Center | 2300 Gasser Rd, Riverton, WY 82501-2204 | 2020-08-03 |
| 1639617145 | Banner Health Physicians West LLC | Clinic/Center | 1356 Shiek St, Wheatland, WY 82201-3231 | 2017-02-03 |
| 1275913105 | Banner Health Physicians West LLC | Clinic/Center | 1 E Whalen Street, Guernsey, WY 82214 | 2015-06-05 |
| 1639682370 | Banner Health Physicians West LLC | Clinic/Center | 1356 Shiek St, Wheatland, WY 82201-3231 | 2017-11-15 |
| 1568909968 | Banner Health Physicians West LLC | Clinic/Center | 443 Big Horn St, Thermopolis, WY 82443-2306 | 2017-01-23 |
| 1942672977 | Banner Health Physicians West LLC | Clinic/Center | 201 14th St, Wheatland, WY 82201-3201 | 2015-10-29 |
| 1962882845 | Banner Health Physicians West LLC | Clinic/Center | 1551 Brice St, Wheatland, WY 82201-3505 | 2015-06-04 |
| 1598145476 | Banner Health Physicians West LLC | Clinic/Center | 222 S 5th St, Douglas, WY 82633-2534 | 2015-06-04 |
| 1568885655 | Banner Health Physicians West LLC | Clinic/Center | 2000 Campbell Dr, Torrington, WY 82240-1528 | 2014-01-27 |
| Street Address |
1800 SPRING RIDGE DR |
| City | SUSANVILLE |
| State | CA |
| Zip Code | 96130-6100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891768271 | Kirk E Lott | Nurse Anesthetist, Certified Registered | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2006-02-08 |
| 1629421797 | Riaz Medical Group Inc | Family Medicine | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2016-07-13 |
| 1033570247 | Sierra Er Department Physicians Medical Group Inc. | Physician Assistant | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2016-03-15 |
| 1780044735 | Matthew S Mccarty Md Inc | General Acute Care Hospital | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2016-03-03 |
| 1043675739 | Mercy Air Service, Inc. | Ambulance | 1800 Spring Ridge Dr, Susanville, CA 96130 | 2015-12-22 |
| 1720463961 | Banner Lassen Medical Center | Clinic/Center | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2015-07-29 |
| 1750788865 | Northstar Radiology - California | Radiology | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2014-12-04 |
| 1043562002 | California Em-i Medical Services, A Medical Corporation | Physician Assistant | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2012-10-15 |
| 1346599305 | Darlene Amy Dougherty | Dietitian, Registered | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2012-09-06 |
| 1124386719 | Rooptown Emergency Physicians, A Medical Corporation | Emergency Medicine | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2012-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932753456 | Shaughn Randall Whittaker | Nurse Practitioner | 1860 Paul Bunyan Rd, Susanville, CA 96130 | 2019-08-01 |
| 1871980847 | Katie Gaffney | Acupuncturist | 1850 Spring Ridge Dr., Susanville, CA 96130 | 2015-04-17 |
| 1952678435 | Linda Vixie | Dentist | 3020 Johnstonville Rd., Susanville, CA 96130 | 2011-11-28 |
| 1942503057 | Pamela Sue Vallalvazo | Counselor | 1445 Paul Bunyon Rd., Susanville, CA 96130 | 2010-12-10 |
| 1255631883 | Jessica Smyth | Counselor | 1400 Chestnut Street # A, Susanville, CA 96130 | 2010-10-29 |
| 1295045276 | Danielle Hardy | Counselor | 1400 Chestnut Street Suite A, Susanville, CA 96130 | 2010-10-08 |
| 1982921417 | Ronald Spencer Tucker Jr. | Counselor | 4119 Johnstonville Road, #270503, Susanville, CA 96130 | 2010-04-23 |
| 1609107945 | Timothy J Nolan | Psychologist | 803 1/2 Main St., Suite 104, Susanville, CA 96130 | 2010-01-27 |
| 1528243649 | Daniel Martin Bruce | Case Manager/Care Coordinator | 720-a Richmond Road, Susanville, CA 96130 | 2008-01-08 |
| 1679757785 | Michael Charles Giddings | Dentist | 475 Rice Canyon Rd, Susanville, CA 96130 | 2007-12-26 |
| Find all providers in zip 96130 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205267549 | Banner Health | Clinic/Center | 1345 A Paul Bunyan Rd, Susanville, CA 96130-3159 | 2013-12-12 |
| 1720463961 | Banner Lassen Medical Center | Clinic/Center | 1800 Spring Ridge Dr, Susanville, CA 96130-6100 | 2015-07-29 |
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| 1164039020 | Crossover Health Medical Group | Clinic/Center | 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 | 2020-09-24 |
| 1104432673 | Aleracare Medical Group of California | Clinic/Center | 17777 Ventura Blvd Ste 220, Encino, CA 91316-3748 | 2020-09-21 |
| 1205447687 | Shawn Richard Oneill | Clinic/Center | 5979 Trotters Ln, Alta Loma, CA 91701-2644 | 2020-08-11 |
| 1134738032 | Healthworks Med Group of California A Medical Corporation | Clinic/Center | 2821 Scott Blvd Ste 2126, Santa Clara, CA 95050-2549 | 2020-07-27 |
| 1437767951 | Miro Health | Clinic/Center | 260 King St Unit 1505, San Francisco, CA 94107-6415 | 2020-07-21 |
| 1598383895 | Alacrity Patient Services, Inc. | Clinic/Center | 1002 N Hudson Ave Apt 1, Los Angeles, CA 90038-2595 | 2020-07-13 |
| 1306464979 | Aleracare Medical Group of California | Clinic/Center | 4849 Van Nuys Blvd Ste 220, Sherman Oaks, CA 91403-2155 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
| City | SUSANVILLE |
| Zip Code | 96130 |
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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.