Individual provider Active NPI

Krameelah Marshae Banks, PHD

  • School Psychologist
  • Little Rock, AR
National Provider Identifier
1245291970
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
05-13P Issued in AR
Practice address
1501 N University Ave
Suite 205
Little Rock, AR 72207-5242
Phone
(501) 960-5779
Fax
(501) 296-9984
NPI assigned
Mar 31, 2006
Last updated
Aug 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 05-13P AR
School Psychologist 103TS0200X 05-13P AR Primary

Addresses

Primary practice location

1501 N University Ave
Suite 205
Little Rock, AR 72207-5242

Mailing address

11800 Pleasant Ridge Rd
#345
Little Rock, AR 72223-2392
Phone (501) 960-5779

Other identifiers 2

IdentifierTypeStateIssuer
5Y322OtherARBXBS
156758719MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05-13PARMDPsychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1245291970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 PLEASANT RIDGE RD",
            "address_2": "#345",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722232392",
            "telephone_number": "501-960-5779",
            "fax_number": "501-219-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N UNIVERSITY AVE",
            "address_2": "SUITE 205",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075242",
            "telephone_number": "501-960-5779",
            "fax_number": "501-296-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "KRAMEELAH",
        "middle_name": "MARSHAE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "05-13P",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AR",
            "license": "05-13P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS",
            "identifier": "5Y322",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156758719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.