NPIMap

Organization Active NPI

Banner Arizona Medical Clinic, LTD

  • Radiology Clinic/Center
  • Sun City West, AZ
National Provider Identifier
1386674240
Registry record updated Sep 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
7-548 Issued in AZ
Legal business name
BANNER ARIZONA MEDICAL CLINIC, LTD
Doing business as
Banner Arizona Medical Clinic, Ltd
Practice address
14418 W Meeker Blvd
Ste 105
Sun City West, AZ 85375-5283
Phone
(623) 583-5240
Fax
(623) 583-5235
NPI assigned
Jul 4, 2006
Last updated
Sep 11, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 11, 2009

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

Authorized official

Name
Margaret A Burke
Title
Chief Financial Officer
Phone
(623) 876-3967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 7-548 AZ Primary

Addresses

Primary practice location

14418 W Meeker Blvd
Ste 105
Sun City West, AZ 85375-5283

Mailing address

14418 W Meeker Blvd
Ste 105
Sun City West, AZ 85375-5283
Phone (623) 583-5240

Other identifiers 1

IdentifierTypeStateIssuer
959520MedicaidAZ

Other names 1

  • Banner Arizona Medical Clinic, Ltd Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peter L Chan MD4 organizations share this tax ID, including this one
Part of
Big Horn Family Med

Other organizations with this tax ID 3

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252627200000",
    "number": "1386674240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14418 W MEEKER BLVD",
            "address_2": "STE 105",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755283",
            "telephone_number": "623-583-5240",
            "fax_number": "623-583-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14418 W MEEKER BLVD",
            "address_2": "STE 105",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755283",
            "telephone_number": "623-583-5240",
            "fax_number": "623-583-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER ARIZONA MEDICAL CLINIC, LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-09-11",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "623-876-3967"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "AZ",
            "license": "7-548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "959520",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Arizona Medical Clinic, Ltd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 11, 2009; 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.