Active NPI
Deidre Joy Banahan
- Massage Therapist
- Belleville, KS
National Provider Identifier
1174033708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3225
- Practice address
- 1913 M St
Belleville, KS 66935-2238 - Phone
- (785) 955-2233
- NPI assigned
- Oct 10, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3225 | NE | Primary |
Addresses
Primary practice location
1913 M St
Belleville, KS 66935-2238
Mailing address
205 Beach St
Cuba, KS 66940-3000
Phone (785) 955-2233
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3225 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507593600000",
"number": "1174033708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 BEACH ST",
"city": "CUBA",
"state": "KS",
"postal_code": "669403000",
"telephone_number": "785-955-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1913 M ST",
"city": "BELLEVILLE",
"state": "KS",
"postal_code": "669352238",
"telephone_number": "785-955-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANAHAN",
"first_name": "DEIDRE",
"middle_name": "JOY",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-10",
"last_updated": "2017-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NE",
"license": "3225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.