Active NPI
Chantay Banikarim, M.D.
- Pediatric Adolescent Medicine Physician
- Phoenix, AZ
National Provider Identifier
1699884890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 30080
- Practice address
- 222 W Thomas Rd
Suite 301
Phoenix, AZ 85013-4419 - Phone
- (602) 406-4772
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 30080 | AZ | Primary |
Addresses
Primary practice location
222 W Thomas Rd
Suite 301
Phoenix, AZ 85013-4419
Mailing address
File 56765
Los Angeles, CA 90074-6765
Phone (602) 406-3860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 761404 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dignity Health | Past | Accepting new patients | |
| The Devereux Foundation | Past | Accepting new patients | |
| The Devereux Foundation | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Phoenix, AZ
- NPI 1306939368
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Scottsdale, AZ
- NPI 1497852768
-
- General Acute Care Hospital
- Redding, CA
- NPI 1477671535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1699884890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE 56765",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900746765",
"telephone_number": "602-406-3860",
"fax_number": "602-406-6132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 W THOMAS RD",
"address_2": "SUITE 301",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134419",
"telephone_number": "602-406-4772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANIKARIM",
"first_name": "CHANTAY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "AZ",
"license": "30080",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "761404",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.