BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC - NPI 1194164681 - Durable Medical Equipment & Medical Supplies in Goodyear, AZ

Q: What is Banner Primary Care Physicians Arizona LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

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About Banner Primary Care Physicians Arizona Llc NPPES

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

BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC (NPI 1194164681) is a healthcare organization registered as a durable medical equipment & medical supplies in Goodyear, Arizona and active in the NPI registry since June 2013. The organization holds a CLIA Microscopy certificate valid through April 8, 2027 and lists Shiva Birdi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1194164681

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NameBANNER PRIMARY CARE PHYSICIANS ARIZONA LLC

Location Address9780 S ESTRELLA PKWYGoodyear, AZ 85338-7114

Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702 · (602) 747-4000

Phone(623) 474-8101

Organization SubpartYesParent: Banner Medical Group

Authorized OfficialShiva BirdiCeo · (602) 747-4000

Enumeration DateJune 18, 2013

Last NPPES UpdateApril 15, 20262 updates tracked since enumeration

NPPES CertifiedApril 15, 2026

✔ NPI 1194164681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

9780 S ESTRELLA PKWY, Goodyear, AZ 85338

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CLIA Laboratory Certificates CMS CLIA

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 for Provider-Performed Microscopy Procedures (PPMP) 03D2057086

Banner Primary Care Physicians Arizona LLC · Goodyear, AZ

Active · expires Apr 8, 2027

CLIA Number03D2057086

Laboratory TypePhysician Office

Certificate Effective DateApril 9, 2025

Certificate Expiration DateApril 8, 2027

Laboratory DirectorDr. Jarrett Riley

Laboratory Phone(623) 474-8101

Laboratory LocationBanner Primary Care Physicians Arizona LLC9780 S Estrella Parkway, Goodyear, AZ 85338

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 6

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

DR. NATHAN ANDREW THOLL M.D.

Family Medicine