Active NPI
Banner-University Medical Center PHX Campus Multispecialty Services
- General Practice Physician
- Phoenix, AZ
National Provider Identifier
1649223686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- BANNER-UNIVERSITY MEDICAL CENTER PHX CAMPUS MULTISPECIALTY SERVICES
- Practice address
- 1111 E McDowell Rd
Phoenix, AZ 85006-2612 - Phone
- (602) 239-2391
- Fax
- (602) 239-4362
- NPI assigned
- May 19, 2006
- Last updated
- Apr 13, 2015
- Organization subpart
- Yes
- Parent organization
- BANNER HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dennis Dahlen
- Title
- Sr Vice President - Finance
- Phone
- (602) 747-4000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | NU | Primary |
Addresses
Primary practice location
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Mailing address
1441 N 12TH St
Phoenix, AZ 85006-2837
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 778847 | Medicaid | AZ |
National Provider Directory
National Provider Directory- Part of
- Big Horn Family Med
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Banner Hospice of Northern Colorado
- Community Based Hospice Care Agency
- Greeley, CO
- NPI 1407409964
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1428883200000",
"number": "1649223686",
"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": "1111 E MCDOWELL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062612",
"telephone_number": "602-239-2391",
"fax_number": "602-239-4362"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BANNER-UNIVERSITY MEDICAL CENTER PHX CAMPUS MULTISPECIALTY SERVICES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BANNER HEALTH",
"enumeration_date": "2006-05-19",
"last_updated": "2015-04-13",
"status": "A",
"authorized_official_last_name": "DAHLEN",
"authorized_official_first_name": "DENNIS",
"authorized_official_title_or_position": "SR VICE PRESIDENT - FINANCE",
"authorized_official_telephone_number": "602-747-4000"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "778847",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
- Banner Urgent Care Services, LLC
- Banner Urgent Care Services, LLC
- Banner Urgent Care Services, LLC
- Banner Urgent Care Services, LLC
- Banner--University Medical Center Phoenix Campus Hospitalist Services
- Banner-University Medical Group
- Sarah SHB Bannister, D.O.
- Larry Louis Bans, M.D.
- Stephen F Bansberg, M.D.
- Wesley Bantilan, RBT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.