NPIMap

Organization Active NPI

Elaine Banta PHD PA

  • Clinical Psychologist
  • Jupiter, FL
National Provider Identifier
1235184920
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY4354FL Issued in FL
Legal business name
ELAINE BANTA PHD PA
Practice address
725 Na1A
Elaine Banta PHD PA Ste B106
Jupiter, FL 33477
Phone
(561) 427-0144
Fax
(561) 747-0258
NPI assigned
May 23, 2006
Last updated
Dec 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Elaine Banta, PHDNPI 1346412780
Title
President
Phone
(561) 427-0144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PY4354FL FL Primary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X NC1669NC NC

Addresses

Primary practice location

725 Na1A
Elaine Banta PHD PA Ste B106
Jupiter, FL 33477

Mailing address

725 Na1A
Elaine Banta PHD PA Ste B106
Jupiter, FL 33477
Phone (561) 427-0144

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1235184920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NA1A",
            "address_2": "ELAINE BANTA PHD PA STE B106",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33477",
            "telephone_number": "561-427-0144",
            "fax_number": "561-747-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NA1A",
            "address_2": "ELAINE BANTA PHD PA STE B106",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33477",
            "telephone_number": "561-427-0144",
            "fax_number": "561-747-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELAINE BANTA PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "BANTA",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-427-0144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4354FL",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "NC1669NC",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.