Organization Active NPI

Banner Greeley Specialists

  • Multi-Specialty Clinic/Center
  • Greeley, AZ
National Provider Identifier
1386929198
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BANNER GREELEY SPECIALISTS
Practice address
5890 W 13TH Street
Suite 114
Greeley, AZ 80634
Phone
(970) 392-5456
NPI assigned
Oct 13, 2011
Last updated
Oct 13, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Dennis E 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 Street
Suite 114
Greeley, AZ 80634

Mailing address

1441 North 12TH Street
Phoenix, AZ 85006

National Provider Directory

National Provider Directory
Tax ID family
Banner Greeley Specialists14 organizations share this tax ID, including this one
Part of
Big Horn Family Med

Other organizations with this tax ID 13

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

View all 13

Locations

5890 W 13th St
Ste 114
Greeley, CO 80634
Phone (970) 378-1000

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1386929198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NORTH 12TH STREET",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 W 13TH STREET",
            "address_2": "SUITE 114",
            "city": "GREELEY",
            "state": "AZ",
            "postal_code": "80634",
            "telephone_number": "970-392-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER GREELEY SPECIALISTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "E",
        "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": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.