NPIMap

Organization Active NPI

Banner Greeley Anesthesia

  • Multi-Specialty Clinic/Center
  • Greeley, CO
National Provider Identifier
1174886758
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BANNER GREELEY ANESTHESIA
Practice address
5890 W 13TH St Ste 102
Greeley, CO 80634-4821
Phone
(970) 348-0090
Fax
(970) 348-0080
NPI assigned
Jun 19, 2012
Last updated
Jun 19, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Authorized official

Name
Dennis Dahlen
Title
Sr VP Finance
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

5890 W 13TH St Ste 102
Greeley, CO 80634-4821

Mailing address

1441 N 12TH St
Phoenix, AZ 85006-2837

National Provider Directory

National Provider Directory
Tax ID family
Banner Greeley Anesthesia3 organizations share this tax ID, including this one
Part of
M E Lee MD

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1174886758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 W 13TH ST STE 102",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344821",
            "telephone_number": "970-348-0090",
            "fax_number": "970-348-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER GREELEY ANESTHESIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "SR VP FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.