NPIMap

Organization Active NPI

Banner University Medical Group Pediatric Sleep, LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1033709357
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
BANNER UNIVERSITY MEDICAL GROUP PEDIATRIC SLEEP, LLC
Practice address
755 E McDowell Rd Annex BLDG
Phoenix, AZ 85006-2502
Phone
(602) 521-3501
Fax
(480) 655-2565
NPI assigned
Jan 20, 2021
Last updated
Dec 28, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER UNIVERSITY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dennis Laraway
Title
Cfo
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X NU Primary

Addresses

Primary practice location

755 E McDowell Rd Annex BLDG
Phoenix, AZ 85006-2502

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702

National Provider Directory

National Provider Directory
Part of
Rodney D Adam MD

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1033709357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 E MCDOWELL RD ANNEX BLDG",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062502",
            "telephone_number": "602-521-3501",
            "fax_number": "480-655-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER UNIVERSITY MEDICAL GROUP PEDIATRIC SLEEP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER UNIVERSITY MEDICAL GROUP",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "LARAWAY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.