NPIMap

Organization Active NPI

Banner Hospital Based Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Loveland, CO
National Provider Identifier
1639417660
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BANNER HOSPITAL BASED PHYSICIANS COLORADO LLC
Practice address
2050 Boise Ave
Ste B
Loveland, CO 80538-5036
Phone
(970) 679-8900
Fax
(970) 679-8940
NPI assigned
Jan 25, 2013
Last updated
Jan 28, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER MEDICAL GROUP COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

2050 Boise Ave
Ste B
Loveland, CO 80538-5036

Mailing address

1441 N 12TH St
Phoenix, AZ 85006-2837

National Provider Directory

National Provider Directory
Tax ID family
Banner Hospital Based Physicians Colorado LLC11 organizations share this tax ID, including this one
Part of
Tiffany Weathers

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1639417660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 BOISE AVE",
            "address_2": "STE B",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805385036",
            "telephone_number": "970-679-8900",
            "fax_number": "970-679-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HOSPITAL BASED PHYSICIANS COLORADO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER MEDICAL GROUP COLORADO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.