NPIMap

Organization Active NPI

Banner Home Care-Arizona

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
National Provider Identifier
1679125009
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BANNER HOME CARE-ARIZONA
Practice address
2140 W Broadway Rd BLDG 7
Mesa, AZ 85202-1895
Phone
(480) 657-1000
NPI assigned
Jul 16, 2019
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Russell Funk
Title
Ceo
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2140 W Broadway Rd BLDG 7
Mesa, AZ 85202-1895

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200102001517 AZ DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 3678482403 Practice locations: Mesa, AZ

Other NPIs with the same Medicare PAC ID 7

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Banner Home Care Arizona2140 W Broadway Rd, Mesa, AZ 85202-1895(480) 657-1000 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy Pumps/Supplies|Pneumatic Compression Devices and/or Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|(TENS) Transcutaneous Electrical Nerve S… Accepts assignmentParticipating since Sep 25, 2014

National Provider Directory

National Provider Directory
Tax ID family
Advanced Home Health in9 organizations share this tax ID, including this one
Part of
M E Lee MD

Other organizations with this tax ID 8

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Banner Health

    dba Banner Payson Medical Center

    • Critical Access Hospital
    • Payson, AZ
    • NPI 1063923340

    Member Of

    NPD member

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1679125009",
    "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": "2140 W BROADWAY RD BLDG 7",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852021895",
            "telephone_number": "480-657-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HOME CARE-ARIZONA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2019-07-16",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "FUNK",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "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 Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.