NPIMap

Organization Active NPI

Banner -- University Medical Center PHX Campus Liver Disease Services

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1992985121
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BANNER -- UNIVERSITY MEDICAL CENTER PHX CAMPUS LIVER DISEASE SERVICES
Practice address
1300 N 12TH St
Phoenix, AZ 85006-2848
Phone
(602) 239-6324
NPI assigned
Nov 5, 2007
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1300 N 12TH St
Phoenix, AZ 85006-2848

Mailing address

1441 N 12TH St
Phoenix, AZ 85006-2837

National Provider Directory

National Provider Directory
Part of
M E Lee MD

Locations

3003 Highway 95
Ste H81
Bullhead City, AZ 86442

2771 Silver Creek Rd
Ste 101
Bullhead City, AZ 86442
Phone (602) 839-2606

1300 N 12th St
Ste 507
Phoenix, AZ 85006
Phone (602) 239-3350

1300 N 12th St
Phoenix, AZ 85006
Phone (602) 239-3927

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1992985121",
    "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": "1300 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062848",
            "telephone_number": "602-239-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER -- UNIVERSITY MEDICAL CENTER PHX CAMPUS LIVER DISEASE SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2007-11-05",
        "last_updated": "2015-04-01",
        "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": []
}

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 1, 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.