Kemba Banyard, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4887 Issued in WI

Practice address

2468 W Lisbon Ave
Milwaukee, WI 53205-1413

Phone

(414) 204-8488

NPI assigned

Jul 24, 2012

Last updated

Sep 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kemba McCain Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Professional Services Group Inc.Group PAC ID 8224296454, 22 clinicians

Outreach Community Health Centers IncGroup PAC ID 1355247735, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Outreach Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1710032669
  Medicare reassignment Care Compare group NPD
• Professional Services Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kenosha, WI
  • NPI 1619024262
  Medicare reassignment Care Compare group NPD
• Tko Homecare

  • Home Health Registered Nurse
  • Milwaukee, WI
  • NPI 1083705966
  NPD (past) Authorized official
• Outreach Community Health Centers, Inc.

  dba Outreach Community Health Ctr at Wellpoint Care Ntwk

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1558231563
  NPD
• Outreach Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1225848021
  NPD (past)
• Outreach Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1134847569
  NPD (past)
• Outreach Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1932357126
  NPD (past)

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1295080521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2468 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051413",
            "telephone_number": "262-977-7771",
            "fax_number": "262-435-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2468 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532051413",
            "telephone_number": "414-204-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANYARD",
        "first_name": "KEMBA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4887",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "4887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEMBA",
            "last_name": "MCCAIN",
            "credential": "FNP-BC DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lakesha Bannister
• Lily Bansemar
• Anton Russell Bansemer
• Matthew Eugene Bantz, PHARMD
• Anna M Banwell, LPC
• Kennetta Banyard
• Alka Chintamani Bapat, MD
• Sarah U Baquer, PA-C, MPH
• Shanice L Baquet
• Fatima Barajas

• Psychiatric/Mental Health Nurse Practitioner in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.