Antoinette Marie Bannister, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

36764 Issued in SC

Practice address

450 Old Greenville Hwy
Clemson, SC 29631-1670

Phone

(864) 653-8964

NPI assigned

May 26, 2006

Last updated

Jan 28, 2025By 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 identifiers 1

Other names 1

• Antoinette Bannister Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abannister55978@direct.ghs.myhfn.org

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217

  Pediatrics

  Medicare reassignment NPD
• Prisma Health University Medical Group

  dba Department of Radiology

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1568799955
  Medicare reassignment NPD
• Prisma Health University Medical Group

  dba Parkside OB-GYN

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  dba Clemson-Seneca Pediatrics-Clemson

  • Pediatrics Physician
  • Clemson, SC
  • NPI 1225480486
  NPD
• Memorial Hospital at Gulfport

  dba Memorial Emergency Physicians

  • Emergency Medicine Physician
  • Gulfport, MS
  • NPI 1962780379
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1174579254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 OLD GREENVILLE HWY",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311670",
            "telephone_number": "864-653-8964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Omni Drive",
            "address_purpose": "LOCATION",
            "city": "Seneca",
            "state": "SC",
            "postal_code": "296729448",
            "country_code": "US",
            "telephone_number": "864-888-4222",
            "fax_number": "864-888-0023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "ANTOINETTE",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "36764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "367640",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abannister55978@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "abannister55978@direct.ghs.myhfn.org",
            "address_1": "111 Omni Drive",
            "city": "Seneca",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296729448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANTOINETTE",
            "last_name": "BANNISTER",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Benson Elliott Bagwell, FNP-BC
• Stephanie Bagwell, NURSE PRACTITIONER
• Gabriela Balardin
• Carrie Balda, CF-SLP
• Rickell Ballentine
• Baptist Easley Hospital (Clemson Neurology)
• Baptist Easley Hospital (Clemson Primary Care)
• Kathryn D Barden, MD
• Christa Marie Barrett, OT
• Roni Ruth Barrett, LPC

• Pediatrics Physician in Clemson, SC
• Providers in Clemson, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.