Individual provider Active NPI

Laura J Banner, NP

  • Family Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1013292382
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN198626 Issued in GA
Practice address
1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3822
Phone
(770) 219-6520
NPI assigned
Oct 18, 2011
Last updated
Oct 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN198626 GA
Family Nurse Practitioner 363LF0000X RN198626 GA Primary

Addresses

Primary practice location

1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3822

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lbanner29963@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111111000369 GA Practitioner - Nurse Practitioner 0244404127 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN198626GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Nurse Practitioner CurrentSince Nov 15, 2011 Accepting new patients

Locations

1315 Jesse Jewell Pkwy NE
Ste 300
Gainesville, GA 30501
Phone (770) 219-6520

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

950 S Enota Dr NE
Ste B
Gainesville, GA 30501
Phone (770) 531-0530

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1013292382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013822",
            "telephone_number": "770-219-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNER",
        "first_name": "LAURA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN198626",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN198626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbanner29963@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1315 Jesse Jewell Pkwy NE Ste 300",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.