Organization
BANNER EXECUTIVE HEALTH LLC
Active
Organization
BANNER EXECUTIVE HEALTH LLC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
PATRICK PENROSE (VP)
(602) 747-4000
Entity
Organization
Contact information
Practice address
4200 E CAMELBACK RD # 102, PHOENIX, AZ 85018-2718
(602) 229-2128
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/03/2023
Last updated
04/16/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up