1. Home
  2. Directory
  3. Arizona
  4. Phoenix
  5. Family Medicine
  6. NPI Profile

BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS FAMILY MEDICINE
NPI 1124073747
Family Medicine in Phoenix, AZ

Active since May 23, 2006CLIA Certified · 3 labs
1300 N 12TH ST, STE 605, PHOENIX, AZ 85006(602) 239-4567(602) 239-2067 Get Directions Write a Review

NPPES record last updated: February 26, 2015. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Banner -- University Medical Center Phoenix Campus Family Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS FAMILY MEDICINE (NPI 1124073747) is a healthcare organization registered as a family medicine in Phoenix, Arizona and active in the NPI registry since May 2006. The organization holds 3 active CLIA laboratory certificates and lists Dennis E Dahlen, Sr Vice President - Finance, as its authorized official.

NPPES Registry Identity

NPI1124073747
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS FAMILY MEDICINE
Location Address1300 N 12TH ST, STE 605Phoenix, AZ 85006-2848
Mailing Address1441 N 12th StPhoenix, AZ 85006-2837
Phone(602) 239-4567
Fax(602) 239-2067
Organization SubpartYesParent: Banner Health
Authorized OfficialDennis E DahlenSr Vice President - Finance · (602) 747-4000
Enumeration DateMay 23, 2006
Last NPPES UpdateFebruary 26, 2015
✔ NPI 1124073747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1300 N 12TH ST, Phoenix, AZ 85006
Open in Google Maps ↗

Other Identifiers 2

Medicaid767618AZ
Medicare PINZ74065AZ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 03D0526218

Banner University Medical Center - Phoenix · Phoenix, AZ
Active · expires Aug 16, 2027
CLIA Number03D0526218
Laboratory TypeHospital
Certificate Effective DateAugust 17, 2025
Certificate Expiration DateAugust 16, 2027
Laboratory DirectorDr. Frank Rybicki
Laboratory Phone(602) 839-6891
Laboratory LocationBanner University Medical Center - Phoenix1111 E Mcdowell Rd, Phoenix, AZ 85006
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 03D0877172

Banner - University Medical Center Phoenix · Phoenix, AZ
Active · expires Aug 16, 2027
CLIA Number03D0877172
Laboratory TypeHospital
Certificate Effective DateAugust 17, 2025
Certificate Expiration DateAugust 16, 2027
Laboratory DirectorDr. Louis J. Novoa-Takara
Laboratory Phone(602) 839-3460
Laboratory LocationBanner - University Medical Center Phoenix1111 E Mcdowell Rd, Phoenix, AZ 85006
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 03D0526219

Banner - University Medical Center Phoenix · Phoenix, AZ
Active · expires Feb 27, 2027
CLIA Number03D0526219
Laboratory TypeHospital
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorDr. Louis J. Novoa-Takara
Laboratory Phone(602) 239-3460
Laboratory LocationBanner - University Medical Center Phoenix1111 E Mcdowell Rd, Phoenix, AZ 85006
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DIANA LYNELLE DABELL M.D.
Emergency Medicine
1300 N 12TH ST, STE 301
PHOENIX, AZ 85006
Maricopa County (602) 839-6968
PINNACLE COLON AND RECTAL SURGEONS, PLLC
Specialist
1300 N 12TH ST, SUITE 619
PHOENIX, AZ 85006
Maricopa County (602) 714-5482
INTERNISTS, ONCOLOGISTS LTD
Internal Medicine (Hematology & Oncology)
1300 N 12TH ST, SUITE 612
PHOENIX, AZ 85006
Maricopa County (602) 258-4875
PHILIP KACZAR MD PC
Internal Medicine
1300 N 12TH ST, SUITE #516
PHOENIX, AZ 85006
Maricopa County (602) 252-3967
BARBARA J RUNQUIST NP
Nurse Practitioner
1300 N 12TH ST, SUITE 404
PHOENIX, AZ 85006
Maricopa County (602) 839-0265
DR. ROBERT DEAN RIERSON MD
Obstetrics & Gynecology
1300 N 12TH ST, SUITE 501
PHOENIX, AZ 85006
Maricopa County (602) 839-4915
MISS FARRAH L BLACK PA
Physician Assistant (Medical)
1300 N 12TH ST, STE 500
PHOENIX, AZ 85006
Maricopa County (602) 839-2606
VIKTORIA KRAJNC MD
Family Medicine
1300 N 12TH ST, SUITE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-5271

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Banner -- University Medical Center Phoenix Campus Family Medicine's NPI number?

The NPI number for Banner -- University Medical Center Phoenix Campus Family Medicine is 1124073747. It was assigned to this organization in the NPPES registry on May 23, 2006.

Where is Banner -- University Medical Center Phoenix Campus Family Medicine located?

Banner -- University Medical Center Phoenix Campus Family Medicine is located at 1300 N 12th St Ste 605, Phoenix, AZ 85006. The listed phone number is (602) 239-4567.

What is Banner -- University Medical Center Phoenix Campus Family Medicine's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Banner -- University Medical Center Phoenix Campus Family Medicine hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Banner -- University Medical Center Phoenix Campus Family Medicine was last updated on February 26, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.