BANNER MEDICAL GROUP GREELEY LLC (NPI# 1972804318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972804318 |
| Entity Type | Organization |
| Organization Name | BANNER MEDICAL GROUP GREELEY LLC |
| Practice Address |
2010 16th St Greeley CO 80631-5162 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 9703505660 |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |
| Authorized Official Name | DENNIS E DAHLEN (SR VP 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 |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992018113 | Banner Medical Group Greeley LLC | Clinic/Center | 2001 70th Ave, Suite 110, Greeley, CO 80634-4621 | 2010-07-16 |
| 1679804223 | Banner Medical Group Greeley LLC | Clinic/Center | 1300 Main St, Windsor, CO 80550-5989 | 2010-01-21 |
| 1104070333 | Banner Medical Group Greeley LLC | Clinic/Center | 5623 W 19th St, Greeley, CO 80634-2901 | 2008-11-14 |
| 1841441870 | Banner Medical Group Greeley LLC | Clinic/Center | 100 S Cherry Ave, Unit 1, Eaton, CO 80615-8255 | 2008-10-08 |
| 1386817880 | Banner Medical Group Greeley LLC | Clinic/Center | 222 Johnstown Center Dr, Johnstown, CO 80534-9030 | 2008-04-07 |
| Street Address |
2010 16TH ST |
| City | GREELEY |
| State | CO |
| Zip Code | 80631-5162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770526337 | North Colorado Medical Center | Home Health | 2010 16th St, Greeley, CO 80631-5188 | 2006-06-13 |
| 1073802971 | Big Thompson Medical Group Inc. | Clinic/Center | 2010 16th St, Ste C, Greeley, CO 80631-5162 | 2011-03-31 |
| 1831418995 | Banner Greeley Specialists | Clinic/Center | 2010 16th St, Ste A, Greeley, CO 80631-5162 | 2010-05-27 |
| 1326214727 | Ryan Robert Mcwilliams | Internal Medicine | 2010 16th St, Ste A, Greeley, CO 80631 | 2008-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395743 | Marcia Martinez | Peer Specialist | 1700 N 17th Ave, Greeley, CO 80631 | 2020-01-14 |
| 1073083036 | Ryan Lawhead | Specialist/Technologist | 270 Alles Dr. D, Butler Hancock Athletic Center, Greeley, CO 80631 | 2018-12-03 |
| 1447766647 | Patricia G Ferguson | Counselor | 14272 Wcr 72, Greeley, CO 80631 | 2017-12-26 |
| 1760902662 | Robert Anthony Rexroad | Counselor | 1300 N. 17th Avenue, Greeley, CO 80631 | 2017-06-21 |
| 1326577750 | Danielle Rodriguez | Psychologist | 1300 N. 17th Ave, Greeley, CO 80631 | 2017-06-08 |
| 1790157865 | Safeway | Pharmacy | 3526 W 10th Street, Greeley, CO 80631 | 2015-10-28 |
| 1245574508 | Jayme L Clapp | Counselor | 1407 8th Ave, Greeley, CO 80631 | 2012-11-26 |
| 1114246006 | Cynthia Melissa Gitler | Emergency Medicine | Banner Health, North Colorado Medical Center, 1601 18th Street, Greenley, CO 80631 | 2010-05-18 |
| 1942438023 | Khoi Dinh Le | Surgery | 1800 15th St., Suite 200, Greeley, CO 80631 | 2009-06-26 |
| 1174760011 | Darwin James Hargrave | Counselor | 912 9th Ave., #222, Greeley, CO 80631 | 2009-01-14 |
| Find all providers in zip 80631 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346794393 | Banner Health Physicians Colorado LLC | Clinic/Center | 1800 15th St Ste G10, Greeley, CO 80631-4595 | 2016-08-08 |
| 1568840742 | Banner Health Physicians Colorado LLC | Clinic/Center | 5890 W 13th St Ste 104, Greeley, CO 80634-4821 | 2015-05-08 |
| 1487918728 | Banner Health Physicians Colorado LLC | Clinic/Center | 6801 W 20th St Unit 201, Greeley, CO 80634-9640 | 2012-07-02 |
| 1174886758 | Banner Greeley Anesthesia | Clinic/Center | 5890 W 13th St Ste 102, Greeley, CO 80634-4821 | 2012-06-19 |
| 1306114475 | Banner Health Physicians Colorado LLC | Clinic/Center | 1800 15th St Ste 300, Greeley, CO 80631-4562 | 2011-12-05 |
| 1295003366 | Banner Health Physicians Colorado LLC | Clinic/Center | 5890 W 13th St Ste 114, Greeley, CO 80634-4821 | 2011-12-05 |
| 1578840021 | Banner Health Physicians Colorado LLC | Clinic/Center | 5890 W 13th St Ste 106, Greeley, CO 80634-4821 | 2011-11-11 |
| 1447532908 | Banner Greeley Specialists | Clinic/Center | 710 11th Ave, Ste 106, Greeley, CO 80631-6405 | 2011-09-12 |
| 1659907376 | Banner Health Physicians Colorado LLC | Clinic/Center | 2001 70th Ave Ste 110, Greeley, CO 80634-4628 | 2020-03-13 |
| 1255971404 | North Colorado Medical Center | Clinic/Center | 1517 16th Avenue Ct, Greeley, CO 80631-4574 | 2020-01-15 |
| Find all providers in GREELEY | ||||
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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.