Individual provider Active NPI

Grant Allen Banks, DPT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1053702019
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7666 Issued in SC
Practice address
355 Woodruff Rd Ste 203
Greenville, SC 29607-3494
Phone
(864) 513-3019
Fax
(864) 712-9270
NPI assigned
Feb 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7666 SC Primary

Addresses

Primary practice location

355 Woodruff Rd Ste 203
Greenville, SC 29607-3494

Mailing address

355 Woodruff Rd Ste 203
Greenville, SC 29607-3494
Phone (864) 513-3019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150406002250 SC Practitioner - Physical Therapist in Private Practice 5193043065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Active Alliance Physical Therapy LLCGroup PAC ID 6709231533, 3 clinicians

Practice addresses (Care Compare)

355 Woodruff Rd
Suite 203
Greenville, SC 29607-3494
Phone (864) 513-3019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Active Alliance Physical Therapy LLC Physical Therapist CurrentSince Aug 31, 2023 Accepting new patients

Locations

355 Woodruff Rd
Ste 203
Greenville, SC 29607
Phone (864) 354-8005

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1053702019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 WOODRUFF RD STE 203",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073494",
            "telephone_number": "864-513-3019",
            "fax_number": "864-712-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 WOODRUFF RD STE 203",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073494",
            "telephone_number": "864-513-3019",
            "fax_number": "864-712-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "GRANT",
        "middle_name": "ALLEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-12",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.