BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC
NPI 1194607457
Clinic/Center - Primary Care in Mesa, AZ

Active since July 25, 2025CLIA 03D2059293 · Microscopy
1917 S CRISMON RD, MESA, AZ 85209(480) 610-7100 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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 1194607457) is a healthcare organization registered as a primary care in Mesa, Arizona and active in the NPI registry since July 2025. The organization holds a CLIA Microscopy certificate valid through May 20, 2027 and lists Shiva Birdi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1194607457
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBANNER PRIMARY CARE PHYSICIANS ARIZONA LLC
Location Address1917 S CRISMON RDMesa, AZ 85209-6216
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702 · (602) 747-4000
Organization SubpartYesParent: Banner Health
Authorized OfficialShiva BirdiCeo · (602) 747-4000
Enumeration DateJuly 25, 2025
NPPES CertifiedJuly 25, 2025
NPI 1194607457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1917 S CRISMON RD, Mesa, AZ 85209

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) 03D2059293

Banner Primary Care Physicians Arizona LLC · Mesa, AZ
Active · expires May 20, 2027
CLIA Number03D2059293
Laboratory TypePhysician Office
Certificate Effective DateMay 21, 2025
Certificate Expiration DateMay 20, 2027
Laboratory DirectorJustin Dufner
Laboratory Phone(480) 610-7100
Laboratory LocationBanner Primary Care Physicians Arizona LLC1917 S Crismon Rd, Mesa, AZ 85209
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 17

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

Internal Medicine
1917 S CRISMON RD
MESA, AZ 85209
Nurse Practitioner (Family)
1917 S CRISMON RD
MESA, AZ 85209
Family Medicine
1917 S CRISMON RD
MESA, AZ 85209
Nurse Practitioner
1917 S CRISMON RD
MESA, AZ 85209
Family Medicine
1917 S CRISMON RD
MESA, AZ 85209
Family Medicine
1917 S CRISMON RD
MESA, AZ 85209
Nurse Practitioner (Family)
1917 S CRISMON RD
MESA, AZ 85209
Psychologist (Health)
1917 S CRISMON RD
MESA, AZ 85209

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 Primary Care Physicians Arizona LLC's NPI number?

The NPI number for Banner Primary Care Physicians Arizona LLC is 1194607457. It was assigned to this organization in the NPPES registry on July 25, 2025.

Where is Banner Primary Care Physicians Arizona LLC located?

Banner Primary Care Physicians Arizona LLC is located at 1917 S Crismon Rd, Mesa, AZ 85209. The listed phone number is (480) 610-7100.

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

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Banner Primary Care Physicians Arizona LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 03D2059293) is associated with this NPI, valid through May 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Banner Primary Care Physicians Arizona LLC was last updated on July 25, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.