Active NPI
John Ramon Banacki, D.C.
- Neurology Chiropractor
- Palm Harbor, FL
National Provider Identifier
1174590095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Chiropractor
- License
- CH4858
- Practice address
- 2429 Alt 19
Palm Harbor, FL 34683-2633 - Phone
- (727) 786-8991
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | CH4858 | FL | Primary |
Addresses
Primary practice location
2429 Alt 19
Palm Harbor, FL 34683-2633
Mailing address
2429 Alt 19
Palm Harbor, FL 34683-2633
Phone (727) 786-8991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74889 | Other | FL | MEDICARE GROUP ID # |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1174590095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2429 ALT 19",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346832633",
"telephone_number": "727-786-8991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2429 ALT 19",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346832633",
"telephone_number": "727-786-8991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANACKI",
"first_name": "JOHN",
"middle_name": "RAMON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "FL",
"license": "CH4858",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP ID #",
"identifier": "74889",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.