Active NPI
John Bannister, RPH
- Pharmacist
- Homer, LA
National Provider Identifier
1194034660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15778
- Practice address
- 833 W Main St
Homer, LA 71040-3322 - Phone
- (318) 927-3523
- Fax
- (318) 927-3526
- NPI assigned
- Oct 1, 2010
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15778 | LA | Primary |
Addresses
Primary practice location
833 W Main St
Homer, LA 71040-3322
Mailing address
126 Carondelet CT
Bossier City, LA 71111-5478
Phone (318) 550-5212
Other practice location 1
200 E Palmetto Ave
Plain Dealing, LA 71064-4258
Phone (318) 326-4759
Other practice location 2
311 Chisum St
Sicily Island, LA 71368-4807
Phone (318) 389-5807
Other practice location 3
2431 Military Rd
Ringgold, LA 71068-2597
Phone (318) 894-0278
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15778 | Other | LA | STATE LICENSE |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15778 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CJ Reynolds Pharmacy Group LLC | Past | Accepting new patients | |
| Ringgold Pharmacy & Wellness, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Ringgold, LA
- NPI 1124667027
-
- Community/Retail Pharmacy
- Ringgold, LA
- NPI 1578353769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649635200000",
"number": "1194034660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 CARONDELET CT",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711115478",
"telephone_number": "318-550-5212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 W MAIN ST",
"city": "HOMER",
"state": "LA",
"postal_code": "710403322",
"telephone_number": "318-927-3523",
"fax_number": "318-927-3526"
}
],
"practiceLocations": [
{
"address_1": "200 E Palmetto Ave",
"address_purpose": "LOCATION",
"city": "Plain Dealing",
"state": "LA",
"postal_code": "710644258",
"country_code": "US",
"telephone_number": "318-326-4759",
"fax_number": "318-326-7383",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "311 Chisum St",
"address_purpose": "LOCATION",
"city": "Sicily Island",
"state": "LA",
"postal_code": "713684807",
"country_code": "US",
"telephone_number": "318-389-5807",
"fax_number": "318-389-1090",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2431 Military Rd",
"address_purpose": "LOCATION",
"city": "Ringgold",
"state": "LA",
"postal_code": "710682597",
"country_code": "US",
"telephone_number": "318-894-0278",
"fax_number": "318-894-0283",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANNISTER",
"first_name": "JOHN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-01",
"last_updated": "2022-04-11",
"certification_date": "2022-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "15778",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "15778",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Homer, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.