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BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC
NPI 1255213518
Clinic/Center - Primary Care in Queen Creek, AZ

Active since July 25, 2025CLIA 03D2054645 · Microscopy
21772 S ELLSWORTH LOOP RD, QUEEN CREEK, AZ 85142(480) 512-3700 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 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 1255213518) is a healthcare organization registered as a primary care in Queen Creek, Arizona and active in the NPI registry since July 2025. The organization holds a CLIA Microscopy certificate valid through April 22, 2027 and lists Shiva Birdi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1255213518
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBANNER PRIMARY CARE PHYSICIANS ARIZONA LLC
Location Address21772 S ELLSWORTH LOOP RDQueen Creek, AZ 85142-7709
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702 · (602) 747-4000
Phone(480) 512-3700
Organization SubpartYesParent: Banner Health
Authorized OfficialShiva BirdiCeo · (602) 747-4000
Enumeration DateJuly 25, 2025
NPPES CertifiedJuly 25, 2025
✔ NPI 1255213518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
21772 S ELLSWORTH LOOP RD, Queen Creek, AZ 85142
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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) 03D2054645

Banner Primary Care Physicians Arizona LLC · Queen Creek, AZ
Active · expires Apr 22, 2027
CLIA Number03D2054645
Laboratory TypePhysician Office
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorVivek R. Kesara
Laboratory Phone(480) 512-3700
Laboratory LocationBanner Primary Care Physicians Arizona LLC21772 S Ellsworth Loop Rd, Queen Creek, AZ 85142
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 20

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

ELIZABETH ANN GEORLETT PA-C
Physician Assistant
21772 S ELLSWORTH LOOP RD
QUEEN CREEK, AZ 85142
Maricopa County (480) 394-4480
JOSHUA EBERHARD D.O.
Pediatrics
21772 S ELLSWORTH LOOP RD
QUEEN CREEK, AZ 85142
Maricopa County (480) 512-3700
JANETTE NICOLE REEVES FNP
Nurse Practitioner (Family)
21772 S ELLSWORTH LOOP RD
QUEEN CREEK, AZ 85142
Maricopa County (480) 512-3700
CHRISTOPHER JAMES BIGGS DO
Internal Medicine
21772 S ELLSWORTH LOOP RD
QUEEN CREEK, AZ 85142
Maricopa County (480) 512-3700
HOLLY MARIA COONEY PA
Physician Assistant
21772 S ELLSWORTH LOOP RD
QUEEN CREEK, AZ 85142
Maricopa County (480) 512-3700
ROSE CECILIA COLUCCI PHARMD
Pharmacist (Ambulatory Care)
21772 S ELLSWORTH LOOP RD
QUEEN CREEK, AZ 85142
Maricopa County (480) 512-3700
VICTORIA CARLSON
Nurse Practitioner
21772 S ELLSWORTH LOOP RD
QUEEN CREEK, AZ 85142
Maricopa County (480) 512-3700
MYKEL CRAIG FREY
Family Medicine
21772 S ELLSWORTH LOOP RD
QUEEN CREEK, AZ 85142
Maricopa County (480) 512-3700

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 1255213518. 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 21772 S Ellsworth Loop Rd, Queen Creek, AZ 85142. The listed phone number is (480) 512-3700.

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 03D2054645) is associated with this NPI, valid through April 22, 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.