Active NPI
Banner Medical Group Adult Sleep, LLC
- Sleep Disorder Diagnostic Clinic/Center
- Mesa, AZ
National Provider Identifier
1558951863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sleep Disorder Diagnostic Clinic/Center
- Legal business name
- BANNER MEDICAL GROUP ADULT SLEEP, LLC
- Practice address
- 2225 W Southern Ave BLDG 1400
Mesa, AZ 85202-4716 - Phone
- (480) 412-3612
- Fax
- (480) 412-8788
- NPI assigned
- Jan 20, 2021
- Last updated
- Dec 28, 2021
- Organization subpart
- Yes
- Parent organization
- BANNER MEDICAL GROUP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dennis Laraway
- Title
- Cfo
- Phone
- (602) 747-4000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Disorder Diagnostic Clinic/Center | 261QS1200X | Primary |
Addresses
Primary practice location
2225 W Southern Ave BLDG 1400
Mesa, AZ 85202-4716
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
National Provider Directory
National Provider Directory- Part of
- Tiffany Weathers
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
5757 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 279-1697
5757 W Thunderbird Rd
Ste 352
Glendale, AZ 85306
Phone (480) 412-3684
Practitioners & affiliated clinicians
Practitioners 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611100800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1640649600000",
"number": "1558951863",
"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": "2225 W SOUTHERN AVE BLDG 1400",
"city": "MESA",
"state": "AZ",
"postal_code": "852024716",
"telephone_number": "480-412-3612",
"fax_number": "480-412-8788"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BANNER MEDICAL GROUP ADULT SLEEP, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BANNER MEDICAL GROUP",
"enumeration_date": "2021-01-20",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A",
"authorized_official_last_name": "LARAWAY",
"authorized_official_first_name": "DENNIS",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "602-747-4000"
},
"taxonomies": [
{
"code": "261QS1200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Sleep Disorder Diagnostic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.