NPIMap

Organization Active NPI

Banner Physician Specialists Arizona LLC

  • Nutrition Education Nutritionist
  • Peoria, AZ
National Provider Identifier
1326710906
Registry record updated Dec 29, 2021
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
9165 W Thunderbird Rd
Peoria, AZ 85381-4847
Phone
(623) 285-1120
Fax
(623) 285-2626
NPI assigned
Oct 1, 2021
Last updated
Dec 29, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Authorized official

Name
Dennis Laraway
Title
Chief Financial Officer
Phone
(602) 747-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Nutrition Education Nutritionist 133NN1002X NU Primary

Addresses

Primary practice location

9165 W Thunderbird Rd
Peoria, AZ 85381-4847

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Anne Marie Zaki MD22 organizations share this tax ID, including this one
Part of
Tiffany Weathers

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1326710906",
    "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": "9165 W THUNDERBIRD RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814847",
            "telephone_number": "623-285-1120",
            "fax_number": "623-285-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER PHYSICIAN SPECIALISTS ARIZONA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "LARAWAY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.