OrganizationActive
Banner Physician Specialists Arizona LLC
NPI 1164150363 · Nutrition Education Nutritionist · Glendale, AZ
Provider details
- NPI number
- 1164150363
- Entity type
- Organization
- Primary specialty
- Nutrition Education NutritionistDietary & Nutritional Service Providers
- Parent organization
- Banner Medical Group
- Organization subpart
- Yes
- Authorized official
- Shiva Birdi, Ceo/Bmg(602) 747-4000
Specialties & taxonomies
Dietary & Nutritional Service Providers
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7701 W Aspera Blvd Stes 102, 201, 301
Glendale, AZ 85308-7935
Phone: (623) 248-2100
Fax: (623) 707-4809
Street-level locationGet directions
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Registry dates
- Enumerated
- 2022-08-15
- Last updated
- 2022-08-15
- Certified
- 2022-08-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.