Banner Churchill Community Hospital
Organization Active NPI General Acute Care Hospital · Fallon, NV
NPI 1023113115 · NPPES record last updated Apr 3, 2026
Key facts
- NPI
- 1023113115
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 638HOS-15 (NV)
- Legal business name
- BANNER CHURCHILL COMMUNITY HOSPITAL
- Practice address
- 801 E Williams Ave
Fallon, NV 89406-3052 - Phone
- (775) 423-3151
- Fax
- (775) 423-3365
- NPI assigned
- Sep 13, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- BANNER HEALTH
Authorized official
- Name
- Dennis Laraway
- Title
- Cfo
- Phone
- (602) 747-4000
Other NPIs on the same Medicare enrollment 1
Member of 1
Practitioners 52
-
Anthony E Albregts, M.D.
-
Wade E Anderson, MD
-
Veer R Babu, MD
-
Star Ray Chenoweth, PA-C
-
Ricardo A Garcia, M.D.
-
Arika Gupta, M.D.
-
Justin Heath, D.O.
-
Misty Kasky, DO
-
Ryan J Kasky, DO
-
Kitae Kim, MD
-
Kristin Anne Laxalt, M.D.
-
Sharon Lynn Maxwell, PA-C, MPAS
-
Thomas Vance McCormick, M.D.
-
Michael Joseph Murray, M.D.
-
Luann D Ochsner, MD
-
Christa Robinson, PA-C
-
Darin Matthew Rolfe, M.D.
-
Cynthia Lynn St. Pierre, M.D.
-
Cesar P Udani, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040701000826 | NV | Part B Supplier - Clinic/Group Practice | 9638080500 |
Receives reassigned benefits from 29 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fallon, NV; Fernley, NV |
National Provider Directory
- Part of
- M E Lee MD
Locations
801 E Williams Ave
Fallon, NV 89406
Phone (775) 423-0310
3061 S Maryland Pkwy
Ste 104
Las Vegas, NV 89109
Phone (702) 438-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 638HOS-15 | NV | Yes |
Addresses
Primary practice location
801 E Williams Ave
Fallon, NV 89406-3052
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Phone (602) 747-4000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1001845 | Medicaid | NV | |
| 1201845 | Medicaid | NV | |
| 1101845 | Medicaid | NV | |
| 3201003 | Medicaid | NV |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Other providers in Fallon, NV
- Apricity Counseling Services PLLC
- Aung K Zaw MD LLC
- Auralcare Hearing Centers of America, LLC
- B & T Investments LLC
- Banner Anesthesiologists West, LLC
- Banner Churchill Community Hospital
- Banner Churchill Community Hospital
- Banner Churchill Community Hospital
- Banner Churchill Community Hospital
- Banner Churchill Community Hospital
All providers in Fallon, NV · General Acute Care Hospital in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.