Jaclyn M Banker, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8983 Issued in SC

Practice address

150 Tanner Rd Ste B
Greenville, SC 29607-5917

Phone

(864) 297-0220

Fax

(864) 297-2335

NPI assigned

Feb 14, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Benchmark Healthcare Services, LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1811213341

  SC

  Medicare reassignment NPD
• Benchmark Health Services

  • Physical Therapist
  • Easley, SC
  • NPI 1457842643
  NPD

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1306143144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 TANNER RD STE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075917",
            "telephone_number": "864-297-0220",
            "fax_number": "864-297-2335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5415 Thompson Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Hoschton",
            "state": "GA",
            "postal_code": "305484132",
            "country_code": "US",
            "telephone_number": "770-965-3508",
            "fax_number": "770-965-3279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANKER",
        "first_name": "JACLYN",
        "middle_name": "M",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-14",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013272",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26642",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL2464",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001852",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004041600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Dodd Baltz, RN
• Austin Bambach
• Halla Ahmed Banafa
• Himabindu Bandarupalli, M.D
• Stephanie Bank, NP
• Andrea Banks, CRNA
• Callie Downs Banks, WHNP-BC
• Cecile Tremain Banks, DPT
• Elizabeth Banks, RN
• Grant Allen Banks, DPT

• Physical Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.