Organization Active NPI

Agh Laveen LLC

Doing business as Dignity Health Arizona General Hospital

  • General Acute Care Hospital
  • Laveen, AZ
National Provider Identifier
1154748416
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H6937 Issued in AZ
Legal business name
AGH LAVEEN LLC
Doing business as
Dignity Health Arizona General Hospital
Practice address
7171 S. 51St Avenue
Laveen, AZ 85339
Phone
(972) 899-6182
NPI assigned
Mar 25, 2014
Last updated
Apr 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Authorized official

Name
Jane Hanson
Title
Ceo
Phone
(480) 410-4523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H6937 AZ Primary

Addresses

Primary practice location

7171 S. 51St Avenue
Laveen, AZ 85339

Mailing address

7171 S 51St Ave
Laveen, AZ 85339-2923

Other names 1

  • Dignity Health Arizona General Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140912001647 AZ Part A Provider - Hospital 4789803370 11 other NPIs on this enrollment
Practice locations: Glendale, AZ; Goodyear, AZ; Laveen, AZ; Surprise, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154748416. Details of each certification follow.

Hospital certification: CCN 030136

Legal name
AGH LAVEEN LLC
Doing business as
DIGNITY HEALTH ARIZONA GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 30, 2015
Last certification
Oct 9, 2019
Beds
16
Ownership / control type
Private (for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 2014 in AZ
Enrollment address
7171 S 51St Ave
Laveen, AZ 85339-2923
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Dignity Health - Arizona General HospitalCCN 030136 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Agh Laveen LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

251 N Estrella Pkwy
Goodyear, AZ 85338
Phone (623) 322-6900

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Aaron J Mickelson Individual Corporate OfficerCmo May 1, 2022
W-2 Managing EmployeeCmo May 1, 2022
Agh Phoenix LLC Organization, Phoenix, AZ LLC, Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2014 100%
Eric T Sorensen Individual Corporate DirectorDirector Nov 1, 2021
Jeffrey Thomas O'Malley Individual Corporate DirectorBoard Member Mar 1, 2020
Commonspirit Health Organization, Chicago, IL Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2019 100%
Operational/Managerial Control Feb 1, 2019 100%
Dignity Health Organization, San Francisco, CA Corporation, Non-profit Other Feb 1, 2019
Peggy Sanborn Individual Corporate DirectorBoard Member Aug 22, 2018
Daniel Morissette Individual Corporate OfficerCfo, Commonspirit Health Feb 1, 2019
OtherCfo, Commonspirit Health Sep 1, 2023
Derek Havens Individual Corporate DirectorDirector May 1, 2022
Steven W Scharmann Individual Corporate OfficerVP, Finance and Rev Cycle Feb 1, 2019
John E Petersdorf Individual Corporate OfficerSVP/ Operations Finance Feb 1, 2019
Larissa Spraker Individual Corporate DirectorDirector Nov 1, 2021
John Bauer Individual Corporate OfficerCfo Nov 4, 2019
W-2 Managing EmployeeCfo Nov 4, 2019
Dignity Community Care Organization, San Francisco, CA Created for acquisition, Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2019 100%
Bradley Pristelski Individual Corporate DirectorBoard Member Mar 1, 2020
Jane Hanson Individual Corporate OfficerCeo Jul 30, 2018
W-2 Managing EmployeeCeo Jul 30, 2018

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 22

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 22

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 123

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 123

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556496000000",
    "number": "1154748416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7171 S 51ST AVE",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 S. 51ST AVENUE",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "85339",
            "telephone_number": "972-899-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGH LAVEEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2019-04-29",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-410-4523"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AZ",
            "license": "H6937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dignity Health Arizona General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laveen, AZ

Sources for this page

Verify at the official NPI Registry.