NPIMap

Organization Active NPI

Banner Physician Specialists Arizona LLC

  • Nutrition Education Nutritionist
  • Sun City West, AZ
National Provider Identifier
1083342273
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
Legal business name
BANNER PHYSICIAN SPECIALISTS ARIZONA LLC
Practice address
14416 W Meeker Blvd
Sun City West, AZ 85375-5284
Phone
(623) 876-3800
Fax
(623) 546-9896
NPI assigned
Aug 15, 2022
Organization subpart
Yes
Parent organization
BANNER MEDICAL GROUPAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Shiva Birdi
Title
Ceo/BMG
Phone
(602) 747-4000

Corporate family (same tax ID) 21

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Banner Physician Specialists Arizona LLC (22 organizations share this tax ID)
Part of
Tiffany Weathers

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

NPPES NPI Registry

Primary practice location

14416 W Meeker Blvd
Sun City West, AZ 85375-5284

Mailing address

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 15, 2022.

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1083342273",
    "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": "14416 W MEEKER BLVD",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755284",
            "telephone_number": "623-876-3800",
            "fax_number": "623-546-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER PHYSICIAN SPECIALISTS ARIZONA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "BIRDI",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_title_or_position": "CEO/BMG",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.