NPIMap

Organization Active NPI

Banner -- University Medical Center Phoenix Campus Trauma Services

  • Medical Specialty Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1952354474
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS TRAUMA SERVICES
Practice address
925 E McDowell Rd
Phoenix, AZ 85006-2502
Phone
(602) 239-2391
Fax
(602) 239-4362
NPI assigned
May 18, 2006
Last updated
Feb 26, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

925 E McDowell Rd
Phoenix, AZ 85006-2502

Mailing address

1441 N 12TH St
Phoenix, AZ 85006-2837

Other identifiers 1

IdentifierTypeStateIssuer
767832MedicaidAZ

National Provider Directory

National Provider Directory
Part of
M E Lee MD

Locations

1300 N 12th St
#512616
Phoenix, AZ 85006
Phone (602) 258-1519

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1952354474",
    "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": "925 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062502",
            "telephone_number": "602-239-2391",
            "fax_number": "602-239-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS TRAUMA SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-02-26",
        "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": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767832",
            "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 Feb 26, 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.

Verify at the official NPI Registry.