Joel Bannister, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306603662 Issued in VA

Practice address

2777 Jefferson Davis Hwy
Suite 109
Stafford, VA 22554-8323

Phone

(540) 318-8615

NPI assigned

Aug 10, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Performance Physical Therapy of Stafford, LLC

  • Physical Therapist
  • Stafford, VA
  • NPI 1083928949
  NPD (past)

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

{
    "created_epoch": "1376092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376092800000",
    "number": "1154754455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 109",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548323",
            "telephone_number": "540-318-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 109",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548323",
            "telephone_number": "540-318-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "JOEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-10",
        "last_updated": "2013-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306603662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Taylor Bakov
• Kiyanda Nyree Baldwin, M.D.
• Tania C Baltes, PHYSICAL THERAPIST
• Hailey Banach
• Christiana Bangura, FNP-C
• Tracy Ann Bannon
• Emily Bare
• Mackenzie Beth Barnes
• Joanna M. Barrette
• Caitlin Barry, LCSW

• Physical Therapy Assistant in Stafford, VA
• Providers in Stafford, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.