NPIMap

Organization Active NPI

Page Hospital

  • Rural Health Clinic/Center
  • Page, AZ
National Provider Identifier
1902317829
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PAGE HOSPITAL
Practice address
601 N Navajo
Page, AZ 86040
Phone
(928) 645-0766
Fax
(928) 645-0767
NPI assigned
Oct 18, 2017
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Ralph Parker
Title
Ceo
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

601 N Navajo
Page, AZ 86040

Mailing address

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

Other names 1

  • Banner Health Clinic - Page Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180118001385 AZ Part A Provider - Rural Health Clinic 5496665861 Practice locations: Page, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902317829. Details of each certification follow.

Rural health clinic certification: CCN 038512

Legal name
PAGE HOSPITAL
Doing business as
BANNER HEALTH CLINIC PAGE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 13, 2019
Last certification
Feb 10, 2022
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
601 N Navajo Dr
Page, AZ 86040-0960
Related CCNs
031304

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Page Hospital Pharmacy4 organizations share this tax ID, including this one
Part of
M E Lee MD

Other organizations with this tax ID 3

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 Hospice of Northern Colorado

    • Community Based Hospice Care Agency
    • Greeley, CO
    • NPI 1407409964

    Member Of

    NPD member

Ownership & related parties

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Julie Ann Alvarado-Dubek Individual Corporate OfficerOfficer Feb 1, 2022
Ralph L Parker Individual Corporate DirectorCeo Nov 23, 2020
W-2 Managing Employee Nov 23, 2020
Marjorie J Bessel Individual Corporate OfficerOfficer Jan 1, 2018
Jean Lance Individual Corporate OfficerClo Jun 30, 2022
Staci Dickerson Individual Corporate OfficerCfo Jul 17, 2023
Carole Faig Individual Corporate DirectorBoard Member Mar 1, 2026
Paris Labruzzo Individual Corporate DirectorSr Director Feb 1, 2026
W-2 Managing Employee Feb 1, 2026
Dean M Harrison Individual Corporate DirectorBoard Member Sep 1, 2023
Anne Mariucci Individual Corporate DirectorDirector Mar 1, 2015
Sujata Gosalia Individual Corporate DirectorDirector Sep 1, 2018
Brenda a Schaefer Individual Corporate OfficerOfficer Mar 6, 2014
Quentin P Smith Individual Corporate DirectorDirector Sep 1, 1999
Vicki Keiser Individual Corporate DirectorDirector Jun 1, 2017
Holly Gregory Individual Corporate DirectorSr Manager Feb 1, 2026
W-2 Managing Employee Feb 1, 2026
Sara Ward Individual Corporate DirectorBoard Member Sep 1, 2023
Michael L Butler Individual Corporate DirectorBoard Member Sep 1, 2025
Mary Schubert Individual Corporate OfficerAssistant Secretary Jan 1, 2024
Amy Perry Individual Corporate OfficerOfficer Nov 1, 2021
Rick Myers Individual Corporate DirectorDirector Sep 1, 2023
John F Koster Individual Corporate DirectorDirector Dec 11, 2015
Mark Wallace Individual Corporate DirectorDirector Sep 1, 2021
Christopher H Volk Individual Corporate DirectorDirector Dec 9, 2009
Michael Garnreiter Individual Corporate DirectorDirector Aug 1, 2012
Banner Health Organization, Phoenix, AZ Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 2018 100%
Operational/Managerial Control Feb 1, 2018 100%

Owners & managing parties with NPI records 12

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Banner Health

    dba Banner Casa Grande Medical Center

    • General Acute Care Hospital
    • Casa Grande, AZ
    • NPI 1003232976

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health

    dba Banner Payson Medical Center

    • Critical Access Hospital
    • Payson, AZ
    • NPI 1063923340

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health

    dba Banner Payson Medical Center - Banner Health Clinic Payson

    • Rural Health Clinic/Center
    • Payson, AZ
    • NPI 1073223012

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health

    dba Banner Payson Medical Center - Banner Health Clinic Pine

    • Rural Health Clinic/Center
    • Pine, AZ
    • NPI 1245940287

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health

    dba Banner Payson Medical Center

    • Medicare Defined Swing Bed Hospital Unit
    • Payson, AZ
    • NPI 1861077414

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health

    dba Banner Ocotillo Medical Center

    • General Acute Care Hospital
    • Chandler, AZ
    • NPI 1972139004

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Marjorie Bessel, MD
    • Internal Medicine Physician
    • Gilbert, AZ
    • NPI 1710002068

    Corporate Officer

    CMS ownership
  • Banner Health
    • Multi-Specialty Clinic/Center
    • Susanville, CA
    • NPI 1205267549

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health

    dba Banner Hospice of Northern Colorado

    • Community Based Hospice Care Agency
    • Greeley, CO
    • NPI 1407409964

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health
    • Radiology Clinic/Center
    • Susanville, CA
    • NPI 1427740570

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health
    • Durable Medical Equipment & Medical Supplies
    • Casper, WY
    • NPI 1528846912

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Banner Health

    dba Banner Fort Collins Medical Center

    • General Acute Care Hospital
    • Fort Collins, CO
    • NPI 1659787554

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 59

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 59

Practitioners & affiliated clinicians

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1902317829",
    "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": "601 N NAVAJO",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "86040",
            "telephone_number": "928-645-0766",
            "fax_number": "928-645-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGE HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2017-10-18",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Health Clinic - Page",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Page, AZ

Sources for this page

Verify at the official NPI Registry.