Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Banner Executive Health LLC

Organization Family Medicine Physician · NPI 1447956107

Banner Executive Health LLC is a Family Medicine Physician in Phoenix, Arizona. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4200 E Camelback Rd # 102
Phoenix, AZ 85018-2718
Phone: (602) 229-2128
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1447956107
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationBanner Health
Authorized official Patrick Penrose — Vp · (602) 747-4000
NPI enumeratedFebruary 3, 2023
Last updated in NPPESApril 16, 2026
Certification dateApril 16, 2026
Mailing address2901 N Central Ave Ste 160, Phoenix, AZ 85012-2702

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