Jacqueline Bannister, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

ARNP9204616 Issued in FL

Practice address

6360 Techster Blvd Ste 1
Fort Myers, FL 33966-4805

Phone

(239) 223-2751

NPI assigned

Jul 3, 2012

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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

87.43 of 100Reported as group

Quality

74.02

Promoting interoperability

100

Improvement activities

40

Cost

77.26

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: jacqueline.bannister.1@13142.direct.athenahealth.com

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194089227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 TECHSTER BLVD STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664805",
            "telephone_number": "239-223-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 TECHSTER BLVD STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664805",
            "telephone_number": "239-223-2751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3920 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339162205",
            "country_code": "US",
            "telephone_number": "239-332-9501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9204616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007338100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jyothsna Priyadarshini Bandaru, M.D.
• George Ernest Bandli III, D.C.
• Surita Banerjee, MD
• Tarsha Banks-Williams, LMHC, NCC
• Jerrica Banks
• Andrew Boby Banooni, M.D.
• Indira Banos Carrera
• Inima Banos Carrera
• Seema Urmilla Bansal-Whitcomb, M.D.
• Julissa Ann Bansee

• Psychiatric/Mental Health Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.