Individual provider Active NPI

Hannah Harper Banach, NP-C

  • Family Nurse Practitioner
  • Waycross, GA
National Provider Identifier
1255947610
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN267919 Issued in GA
Practice address
303 Darling Ave
Waycross, GA 31501-5223
Phone
(912) 283-1717
NPI assigned
Sep 21, 2020
Last updated
Sep 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN267919 GA Primary

Addresses

Primary practice location

303 Darling Ave
Waycross, GA 31501-5223

Mailing address

303 Darling Ave
Waycross, GA 31501-5223
Phone (912) 283-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20201214002648 GA Practitioner - Nurse Practitioner 9133531213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

1900 Tebeau St
Waycross, GA 31501-6357
Phone (912) 283-3030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lina Heath Harper, M.D., P.C. CurrentSince Sep 28, 2020 Accepting new patients
Acs Primary Care Physicians - Southeast PC CurrentSince Sep 1, 2024 Accepting new patients

Locations

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

303 Darling Ave
Waycross, GA 31501
Phone (912) 283-1717

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEBEBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CEBEBA/Endpoint/CEBEBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1255947610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 DARLING AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015223",
            "telephone_number": "912-283-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 DARLING AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015223",
            "telephone_number": "912-283-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANACH",
        "first_name": "HANNAH",
        "middle_name": "HARPER",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN267919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.