| Banner Childrens Banner Health Clinic Llc | |
|
2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 | |
| (602) 747-4000 | |
| Not Available |
| Full Name | Banner Childrens Banner Health Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2901 N Central Ave Ste 160, Phoenix, Arizona |
| Authorized Official Name and Position | Shiva Birdi (CEO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Childrens Banner Health Clinic Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Childrens Banner Health Clinic Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: (602) 747-4000 |
| NPI Number | 1407191216 |
|---|---|
| Provider Enumeration Date | 12/05/2012 |
| Last Update Date | 07/30/2024 |
| Medicare PECOS PAC ID | 2466697735 |
|---|---|
| Medicare Enrollment ID | O20130315000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407191216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kelly F England |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679563282 PECOS PAC ID: 2264421478 Enrollment ID: I20040511001246 |
| Provider Name | Farha N Khan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073584611 PECOS PAC ID: 6901824754 Enrollment ID: I20051109001172 |
| Provider Name | Marcela Cristea |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013999226 PECOS PAC ID: 8123033677 Enrollment ID: I20060220000553 |
| Provider Name | John G Sarmiento |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598743478 PECOS PAC ID: 9133287238 Enrollment ID: I20081017000637 |
| Provider Name | Gina D Montion |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366435612 PECOS PAC ID: 2062551336 Enrollment ID: I20100111000771 |
| Provider Name | Zafar Quadir |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457371759 PECOS PAC ID: 7113943002 Enrollment ID: I20110421000613 |
| Provider Name | Dawn M Sorenson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821246091 PECOS PAC ID: 4385801554 Enrollment ID: I20120131000859 |
| Provider Name | Alyson Boone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467772434 PECOS PAC ID: 8224289731 Enrollment ID: I20121109000472 |
| Provider Name | Michelle D Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902896590 PECOS PAC ID: 2466697503 Enrollment ID: I20130320000771 |
| Provider Name | Ruben O Espinoza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164621470 PECOS PAC ID: 8022253186 Enrollment ID: I20130321000167 |
| Provider Name | Tracy Frausto |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164527396 PECOS PAC ID: 3375788433 Enrollment ID: I20130321000198 |
| Provider Name | Brenda M Kronborg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801886163 PECOS PAC ID: 2264677228 Enrollment ID: I20130321000236 |
| Provider Name | Mehdi Salek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215903836 PECOS PAC ID: 2466697420 Enrollment ID: I20130321000323 |
| Provider Name | Joseph L Werther |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629096458 PECOS PAC ID: 5092950063 Enrollment ID: I20130321000345 |
| Provider Name | Trupti V Amin-chapman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164412854 PECOS PAC ID: 6709021777 Enrollment ID: I20130321000372 |
| Provider Name | Manu Bhakoo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518952373 PECOS PAC ID: 9335195403 Enrollment ID: I20130325000381 |
| Provider Name | Wendy L Lorenzen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386634954 PECOS PAC ID: 5496990384 Enrollment ID: I20130325000520 |
| Provider Name | Scott S Schnee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255330973 PECOS PAC ID: 0143465625 Enrollment ID: I20130404000312 |
| Provider Name | Suzanne J Nielsen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457526030 PECOS PAC ID: 9537306782 Enrollment ID: I20130508000310 |
| Provider Name | Russell Horton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780996967 PECOS PAC ID: 9537308663 Enrollment ID: I20130620000196 |
| Provider Name | Jaclyn M Kepski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538484357 PECOS PAC ID: 3375782410 Enrollment ID: I20130620000406 |
| Provider Name | Carlos J Ventura |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174842884 PECOS PAC ID: 4082856745 Enrollment ID: I20130808000176 |
| Provider Name | Jonathan M Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982826855 PECOS PAC ID: 9537318209 Enrollment ID: I20150929000646 |
| Provider Name | Melinda Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487026167 PECOS PAC ID: 9638470511 Enrollment ID: I20151217002534 |
| Provider Name | Aaron Gomez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932442712 PECOS PAC ID: 4981995875 Enrollment ID: I20160623002159 |
| Provider Name | Kojasteh M Ghaziaskar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881663441 PECOS PAC ID: 4385930742 Enrollment ID: I20160910000284 |
| Provider Name | Nurul Hariadi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881875037 PECOS PAC ID: 1951699495 Enrollment ID: I20161016000001 |
| Provider Name | Jacquelyn Pichette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891161055 PECOS PAC ID: 9830470954 Enrollment ID: I20170104001550 |
| Provider Name | Randi Michelle Herman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962947770 PECOS PAC ID: 4688958325 Enrollment ID: I20170224001640 |
| Provider Name | Mwela Njabi Asombang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184937989 PECOS PAC ID: 5294030698 Enrollment ID: I20170518002865 |
| Provider Name | James Roy Stangle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790206159 PECOS PAC ID: 1850651050 Enrollment ID: I20180208000973 |
| Provider Name | Angela Do Feng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144684036 PECOS PAC ID: 7315235231 Enrollment ID: I20190712002924 |
| Provider Name | Saisho Mangla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235543919 PECOS PAC ID: 6507083060 Enrollment ID: I20191006000018 |
| Provider Name | Virginia Burford Hatch-pigott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457325664 PECOS PAC ID: 0547227175 Enrollment ID: I20191016000566 |
| Provider Name | Jamie Quintana |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962675264 PECOS PAC ID: 5092882530 Enrollment ID: I20200520001548 |
| Provider Name | Zaydee Montano Rivera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427579754 PECOS PAC ID: 4385063577 Enrollment ID: I20201008000924 |
| Provider Name | Marta K Szymaszek-cusick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578094603 PECOS PAC ID: 6103237359 Enrollment ID: I20201119002871 |
| Provider Name | Renee A Mercer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467816058 PECOS PAC ID: 1153696877 Enrollment ID: I20201210000914 |
| Provider Name | Joshua Eberhard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073923793 PECOS PAC ID: 5193093326 Enrollment ID: I20210127001431 |
| Provider Name | Courtney Agliano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417431586 PECOS PAC ID: 3971919796 Enrollment ID: I20210302003239 |
| Provider Name | Jarrett Riley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255623732 PECOS PAC ID: 5193941946 Enrollment ID: I20210423001808 |
| Provider Name | Tanya Pitts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124062435 PECOS PAC ID: 9830140441 Enrollment ID: I20210426002920 |
| Provider Name | Joseph Robert Armstrong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134625486 PECOS PAC ID: 1153722939 Enrollment ID: I20210630003053 |
| Provider Name | David Lar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962636845 PECOS PAC ID: 7416103841 Enrollment ID: I20210701000809 |
| Provider Name | Marie Christianne Sandhya Ravi Chandar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386130060 PECOS PAC ID: 8325395098 Enrollment ID: I20210831002092 |
| Provider Name | Julia Gray Farber |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356873996 PECOS PAC ID: 1557752995 Enrollment ID: I20211220001650 |
| Provider Name | Maria C Martin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720585805 PECOS PAC ID: 8123417755 Enrollment ID: I20220616002415 |
| Provider Name | Breeane R. Wazney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538722822 PECOS PAC ID: 0840523346 Enrollment ID: I20220701000767 |
| Provider Name | Beau Gordon Palmer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497217517 PECOS PAC ID: 3779965702 Enrollment ID: I20220808000462 |
| Provider Name | Jalaja Gundrathi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699126771 PECOS PAC ID: 2466780499 Enrollment ID: I20220817003687 |
| Provider Name | Holly P Jastak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023541869 PECOS PAC ID: 0446583330 Enrollment ID: I20220921001547 |
| Provider Name | Meggan Ann Murphy Roman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871122861 PECOS PAC ID: 4880055078 Enrollment ID: I20230803004413 |
| Provider Name | Krishnamraju Kosuru |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013204296 PECOS PAC ID: 2264743053 Enrollment ID: I20240611003569 |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
My Family Doctor In The Valley Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Deborah L Dykema Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 | |
Scottsdale Housecall Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Wings Of Hope Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 205, Phoenix, AZ 85029 Phone: 602-971-0304 Fax: 602-971-0305 | |
Sheperd Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9150 W Indian School Rd Ste 111b, Phoenix, AZ 85037 Phone: 623-247-2300 Fax: 623-247-1939 |