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Banner Medical Group Care Gap LLC — NPI 1942058672, Phoenix, AZ | NPI Central

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NPI 1942058672

OrganizationActive

Banner Medical Group Care Gap LLC

NPI 1942058672 · Multi-Specialty Clinic/Center · Phoenix, AZ

Provider details

NPI number: 1942058672
Entity type: Organization
Primary specialty: Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
Parent organization: Banner Health
Organization subpart: Yes
Authorized official: Shiva Birdi, Ceo/Bmg(602) 747-4000

Specialties & taxonomies

Multi-Specialty Clinic/CenterPrimary261QM1300X
Ambulatory Health Care Facilities

Practice location

2901 N Central Ave Ste 160

Phoenix, AZ 85012-2702

Phone: (602) 747-4000

Approximate (ZIP-level) locationGet directions

More AZ providers

Mailing address

2901 N Central Ave Ste 160

Phoenix, AZ 85012-2702

Additional practice locations (1)

4720 E Greenway Rd
Phoenix, AZ 85032-4355
Phone: (602) 439-6000

Registry dates

Enumerated: 2024-05-08
Last updated: 2026-04-20
Certified: 2026-04-20

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.