Active NPI
Alan Grey Banner, RPH
- Pharmacist
- Statesville, NC
National Provider Identifier
1073693776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 05610
- Practice address
- 3478 E Broad St
Statesville, NC 28625-4523 - Phone
- (704) 878-6681
- Fax
- (704) 878-6684
- NPI assigned
- Oct 17, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 05610 | NC | Primary |
Addresses
Primary practice location
3478 E Broad St
Statesville, NC 28625-4523
Mailing address
116 Morning Dove LN
Statesville, NC 28625-2709
Phone (704) 876-8707
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0496471 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05610 | NC | MD | Pharmacist |
Organizations & group practices 2
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": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1073693776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 MORNING DOVE LN",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286252709",
"telephone_number": "704-876-8707",
"fax_number": "704-878-6684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3478 E BROAD ST",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286254523",
"telephone_number": "704-878-6681",
"fax_number": "704-878-6684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNER",
"first_name": "ALAN",
"middle_name": "GREY",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "05610",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0496471",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
- James Michael Baker, LPC, LCAS
- Angela Lunsford Baldwin, CRNA
- Candice Elyse Ball, APRN
- Misty Ballinger, RDH
- Amy Kathleen Balok
- Jennifer Barchers, RN
- Barium Springs Home for Children (Children's Hope Alliance)
- Barium Springs Home for Children (Children's Hope Alliance)
- Barium Springs Home for Children
- Barium Springs Home for Children (Children's Hope Alliance)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.