Individual provider Active NPI

Karly Andrea Keahi Bannister, L.AC.

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1275833576
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
150426 Issued in OR
Practice address
2926 SE 20TH Ave
Portland, OR 97202-2235
Phone
(971) 998-7781
NPI assigned
Nov 2, 2010
Last updated
Nov 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 150426 OR Primary

Addresses

Primary practice location

2926 SE 20TH Ave
Portland, OR 97202-2235

Mailing address

2926 SE 20TH Ave
Portland, OR 97202-2235
Phone (971) 998-7781

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

State licenses

LicenseStateTypeSpecialty
150426ORMDAcupuncturist

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": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1275833576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 SE 20TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022235",
            "telephone_number": "971-998-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 SE 20TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022235",
            "telephone_number": "971-998-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "KARLY",
        "middle_name": "ANDREA KEAHI",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "150426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.