Banner Colorado Specialty Clinic

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BANNER COLORADO SPECIALTY CLINIC

Practice address

1801 16TH St
Greeley, CO 80631-5154

Phone

(970) 352-4121

Fax

(970) 350-6140

NPI assigned

May 28, 2006

Organization subpart

Yes

Parent organization

BANNER HEALTHAs reported in NPPES

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

Authorized official

Name

Dennis E Dahlen

Title

Sr Vice President - Finance

Phone

(602) 747-4000

Specialties & licenses 1

Addresses

Part of

M E Lee MD

Member of 1

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

• Banner Health

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340

  Member Of

  NPD member

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192924800000",
    "number": "1811944390",
    "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": "1801 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315154",
            "telephone_number": "970-352-4121",
            "fax_number": "970-350-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER COLORADO SPECIALTY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2006-05-28",
        "last_updated": "2007-10-21",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SR VICE PRESIDENT - FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dejanae Gayle Bankhead, LMT
• Banner Anesthesiologists Colorado LLC
• Banner Anesthesiologists Colorado LLC
• Banner Cancer Center Specialists Colorado LLC
• Banner Cancer Center Specialists Colorado LLC
• Banner Greeley Anesthesia
• Banner Greeley Anesthesia
• Banner Greeley Specialists
• Banner Greeley Specialists
• Banner Greeley Specialists

• Multi-Specialty Clinic/Center in Greeley, CO
• Providers in Greeley, CO by specialty
• Multi-Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2007; 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.