Banner Health

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

BANNER HEALTH

Practice address

1800 Spring Ridge Dr
Susanville, CA 96130-6100

Phone

(530) 252-2000

NPI assigned

May 25, 2023

Last updated

Jul 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra Dugger

Title

Ceo

Phone

(530) 252-2000

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Banner Health

  • Multi-Specialty Clinic/Center
  • Susanville, CA
  • NPI 1205267549

  9537078365

  Same PAC ID
• Banner Health

  dba Banner Casa Grande Medical Center

  • General Acute Care Hospital
  • Casa Grande, AZ
  • NPI 1003232976

  9537078365

  Same PAC ID
• Banner Health

  dba Banner Payson Medical Center

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340

  9537078365

  Same PAC ID
• Banner Health

  dba Banner Payson Medical Center - Banner Health Clinic Payson

  • Rural Health Clinic/Center
  • Payson, AZ
  • NPI 1073223012

  9537078365

  Same PAC ID
• Banner Health

  dba Banner Payson Medical Center - Banner Health Clinic Pine

  • Rural Health Clinic/Center
  • Pine, AZ
  • NPI 1245940287

  9537078365

  Same PAC ID
• Banner Health

  dba Banner Hospice of Northern Colorado

  • Community Based Hospice Care Agency
  • Greeley, CO
  • NPI 1407409964

  9537078365

  Same PAC ID
• Banner Health

  • Durable Medical Equipment & Medical Supplies
  • Casper, WY
  • NPI 1528846912

  9537078365

  Same PAC ID
• Banner Health

  dba Banner Fort Collins Medical Center

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1659787554

  9537078365

  Same PAC ID
• Banner Health

  dba Banner Payson Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Payson, AZ
  • NPI 1861077414

  9537078365

  Same PAC ID
• Banner Health

  dba Banner Ocotillo Medical Center

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1972139004

  9537078365

  Same PAC ID

Tax ID family

Banner - University Hospital Based Physicians LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Banner - University Hospital Based Physicians LLC

  • Radiology Clinic/Center
  • Phoenix, AZ
  • NPI 1427768381
  NPD tax ID
• Banner - University Hospital Based Physicians LLC

  • Radiology Clinic/Center
  • Phoenix, AZ
  • NPI 1457061319
  NPD tax ID
• Banner - University Hospital Based Physicians LLC

  • Radiology Clinic/Center
  • Phoenix, AZ
  • NPI 1700596665
  NPD tax ID

All facility ownership & control disclosures 61

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 80

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Banner Lassen Medical Center

  • Critical Access Hospital
  • Susanville, CA
  • NPI 1538197231

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Lassen Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Susanville, CA
  • NPI 1922334846

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner - University Medical Center Phoenix

  • Psychiatric Hospital Unit
  • Phoenix, AZ
  • NPI 1629122171

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner - University Medical Center South Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1558759498

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Banner - University Medical Center South Campus LLC

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1801284617

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner - University Medical Center South Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1922660182

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Banner - University Medical Center Tucson Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265820179

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner - University Medical Center Tucson Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1861102881

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Behavioral Health Hospital

  • Psychiatric Hospital
  • Scottsdale, AZ
  • NPI 1942319199

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Boswell Medical Center

  • General Acute Care Hospital
  • Sun City, AZ
  • NPI 1952560914

  5% Or Greater Direct Ownership Interest

  CMS ownership

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Banner Health

  • Multi-Specialty Clinic/Center
  • Susanville, CA
  • NPI 1205267549
  NPPES parent name
• Banner Lassen Medical Center

  • Critical Access Hospital
  • Susanville, CA
  • NPI 1538197231
  NPPES parent name
• Banner Lassen Medical Center

  • Multi-Specialty Clinic/Center
  • Susanville, CA
  • NPI 1720463961
  NPPES parent name
• Banner Lassen Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Susanville, CA
  • NPI 1922334846
  NPPES parent name

Practitioners 10

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.

• Jeffrey Steven Fountain, D.O.

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1245420447

  NV

  Medicare reassignment NPD
• Sandra Jill Althaus, M.D.

  • Diagnostic Radiology Physician
  • Carson City, NV
  • NPI 1326048018
  Medicare reassignment NPD
• Nicholas John Carlevato, MD

  • Vascular & Interventional Radiology Physician
  • Elko, NV
  • NPI 1457383812
  Medicare reassignment NPD
• Hubert Chin, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1952324121
  Medicare reassignment NPD
• Eric Lawrence Goldberg, MD

  • Diagnostic Radiology Physician
  • Edina, MN
  • NPI 1699763508

  NV

  Medicare reassignment NPD
• John L Griffith, M.D.

  • Diagnostic Radiology Physician
  • Fallon, NV
  • NPI 1053351510
  Medicare reassignment NPD
• Leon S Jackson, MD

  • Diagnostic Radiology Physician
  • Winnemucca, NV
  • NPI 1285622175
  Medicare reassignment NPD
• Eric Joseph Kraemer, MD

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
  • NPI 1881621621

  NV

  Medicare reassignment NPD
• Robert Grierson Leckie, MD

  • Diagnostic Radiology Physician
  • Winnemucca, NV
  • NPI 1861490559
  Medicare reassignment NPD
• Randall Allan Pierce, MD

  • Diagnostic Radiology Physician
  • Sparks, NV
  • NPI 1174511067
  Medicare reassignment NPD

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1427740570",
    "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",
            "telephone_number": "602-747-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SPRING RIDGE DR",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961306100",
            "telephone_number": "530-252-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "DUGGER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-252-2000"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Grace Baker, L.V.N.
• Mathilda Kathleen Baker
• Molly Baker
• Rebecca Ann Baker
• Banner Health
• Banner Health Physicians West LLC
• Banner Lassen Medical Center
• Banner Lassen Medical Center
• Banner Lassen Medical Center
• George Barakat, M.D.

• Radiology Clinic/Center in Susanville, CA
• Providers in Susanville, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.