Banner Arizona ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC3833 Issued in AZ

Legal business name

BANNER ARIZONA ASC LLC

Doing business as

Sun City West Ambulatory Surgery Center

Practice address

14416 W Meeker Blvd
Suite 103
Sun City West, AZ 85375-5284

Phone

(623) 583-5280

Fax

(623) 583-5277

NPI assigned

Feb 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Phillip A Clendenin

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other names 1

• Sun City West Ambulatory Surgery Center Doing business as

Locations

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1417921537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14416 W MEEKER BLVD",
            "address_2": "SUITE 103",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755284",
            "telephone_number": "623-583-5280",
            "fax_number": "623-583-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14416 W MEEKER BLVD",
            "address_2": "SUITE 103",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755284",
            "telephone_number": "623-583-5280",
            "fax_number": "623-583-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER ARIZONA ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC3833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun City West Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Virginia Martha Baker, RN, IBCLC-R
• Jane R Balderson, PT, DPT
• Salina Nicole Baldwin, D.O.
• Vincent Wayne Baldwin, PT, DPT
• Braxton Ball
• Banner Arizona Medical Clinic LTD
• Banner Arizona Medical Clinic LTD
• Banner Arizona Medical Clinic LTD
• Banner Arizona Medical Clinic, LTD
• Banner del E Webb Medical Center

• Ambulatory Surgical Clinic/Center in Sun City West, AZ
• Providers in Sun City West, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.