Wendy Song (NPI# 1144660671, PAC ID# 5597050211) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1144660671 |
| PAC ID by PECOS | 5597050211 |
| Professional Enrollment ID | I20160819001543 |
| Full Name | Wendy Song |
| Organization Legal Name | BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC |
| Address |
17900 N Porter Rd Maricopa AZ 85138-4228 |
| Phone Number | 5202332500 |
| Gender | F |
| Medical School | NOVA SOUTHEASTERN UNIV COLLEGE OF DENTAL MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6406020155 |
| Number of Group Practice Members | 148 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 030016 | BANNER CASA GRANDE MEDICAL CENTER |
| 030122 | BANNER GATEWAY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 17900 N Porter Rd, Maricopa, AZ 85138-4228 | 5202332500 | BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC |
| 117 E Main St, Suite A100, Payson, AZ 85541-4606 | 9285964500 | BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC |
| Organization Legal Name | BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC |
| Physicians | 129 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly Koike | Family Medicine | Banner Primary Care Physicians Arizona LLC | 4720 E Greenway Rd, Phoenix, AZ 85032-4355 |
| Angela Do Feng | Family Medicine | Banner Primary Care Physicians Arizona LLC | 1950 S Country Club Dr, Suite 101, Mesa, AZ 85210-6044 |
| Swathi Ponnathota | Internal Medicine | Banner Primary Care Physicians Arizona LLC | 1811 E Mcmurray Blvd, Casa Grande, AZ 85122-5404 |
| Deborah L Mcgarry | Nurse Practitioner | Banner Primary Care Physicians Arizona LLC | 1917 S Crismon Rd, Mesa, AZ 85209-6216 |
| Esther Kamau | Nurse Practitioner | Banner Primary Care Physicians Arizona LLC | 20751 W Market St, Buckeye, AZ 85396-7893 |
| William N Bottomley | Family Medicine | Banner Primary Care Physicians Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Jeffrey R Smolin | Physician Assistant | Banner Primary Care Physicians Arizona LLC | 155 E Warner Rd, Gilbert, AZ 85296-3082 |
| Christina Joyave | Nurse Practitioner | Banner Primary Care Physicians Arizona LLC | 1435 S Alma School Rd, Chandler, AZ 85286-7144 |
| Melody D Austin | Nurse Practitioner | Banner Primary Care Physicians Arizona LLC | 8510 W Deer Valley Rd, Suite 100, Peoria, AZ 85382-5386 |
| Andrea W Mathiason | Nurse Practitioner | Banner Primary Care Physicians Arizona LLC | 4860 N Litchfield Rd, Suite 102, Litchfield Park, AZ 85340-5040 |
| Street Address |
17900 N PORTER RD |
| City | MARICOPA |
| State | AZ |
| Zip | 85138-4228 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William N Bottomley | Family Medicine | Banner Primary Care Physicians Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Adireddy Kamireddy | Internal Medicine | Banner Primary Care Physicians Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Gregory Brian Bechill | Family Medicine | Banner Primary Care Physicians Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Simon M Sheard | Family Medicine | Banner Primary Care Physicians Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Charles A Richardson | Family Medicine | Banner Primary Care Physicians Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Leslie Kaye Bolander | Certified Nurse Midwife (cnm) | Banner Physician Specialists Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Sohaib A Kayani | Obstetrics/gynecology | Banner Physician Specialists Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Rishi Basnyat | Internal Medicine | Banner Primary Care Physicians Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Lindsay Allen | Obstetrics/gynecology | Banner Physician Specialists Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Anne Donos | Nurse Practitioner | Banner Primary Care Physicians Arizona LLC | 17900 N Porter Rd, Maricopa, AZ 85138-4228 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bart A Gobeli | Chiropractic | 22043 N O Sullivan Dr, Maricopa, AZ 85138-2288 | |
| Russell A Webb | Chiropractic | 44400 W Honeycutt Rd, Suite 101, Maricopa, AZ 85138-2945 | |
| Kyle K Mcdevitt | Nurse Practitioner | Sun Life Family Health Center Inc | 44572 W Bowlin Rd, Maricopa, AZ 85138-4558 |
| Stella C Raposas | Pediatric Medicine | Sun Life Family Health Center Inc | 44572 W Bowlin Rd, Maricopa, AZ 85138-4558 |
| Timothy G Mcfarland | Chiropractic | 43553 W Askew Dr, Maricopa, AZ 85138-8920 |
| City | MARICOPA |
| Zip Code | 85138 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MARICOPA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Wendy Song.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.