Banner Health Physicians Colorado LLC
Organization Active NPI Multi-Specialty Clinic/Center · Wray, CO
NPI 1306185699 · NPPES record last updated Apr 15, 2026
Key facts
- NPI
- 1306185699
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- BANNER HEALTH PHYSICIANS COLORADO LLC
- Practice address
- 1017 W 7TH St
Wray, CO 80758-1420 - Phone
- (970) 332-2225
- NPI assigned
- Feb 6, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- BANNER MEDICAL GROUP COLORADO
Authorized official
- Name
- Shiva Birdi
- Title
- Ceo
- Phone
- (602) 747-4000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111219000237 | CO | Part B Supplier - Clinic/Group Practice | 8921273038 |
Receives reassigned benefits from 380 practitioners This NPI is an additional NPI on the enrollment Practice locations: Loveland, CO; Yuma, CO; Sterling, CO; Timnath, CO; Wellington, CO; Windsor, CO; Wray, CO; Fort Collins, CO… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
1017 W 7TH St
Wray, CO 80758-1420
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other providers in Wray, CO
- Ageless Essentials LLC
- Karen Allison
- Lisa Mae Arkulari
- Chelsea Lynae Barnts
- Madeline Bauer
- Stephen Rex Brethauer
- Erin Marie Carper
- Cedardale Health Care Centre, Inc.
All providers in Wray, CO · Multi-Specialty Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 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.