Laura Bannister, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00009881 Issued in WA

Practice address

2612 3Rd Avenue
Seattle, WA 98121

Phone

(206) 686-4073

Fax

(206) 260-4565

NPI assigned

Dec 2, 2005

Last updated

Jun 17, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laura Jo Nelson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ravenna Physical Therapy LLC

  dba Avant Physical Therapy

  • Physical Therapy Clinic/Center
  • Seattle, WA
  • NPI 1467834762
  NPD (past) Authorized official

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1083698070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 NE 75TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981154372",
            "telephone_number": "206-854-1809",
            "fax_number": "206-260-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 3RD AVENUE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98121",
            "telephone_number": "206-686-4073",
            "fax_number": "206-260-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "LAURA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "NELSON",
            "middle_name": "JO",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deshayla Banks
• Kristy Banks
• Maralyssa Angelique Bann, M.D.
• Lael B Banner, DDS
• Kelly Bannister
• Logan Stephen Bannon
• Esther Bannwart, LMP
• Gaurav Kumar Bansal, D.O.
• Hitashi Bansal
• Manju Bala Bansal

• Physical Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.