Renee Marie Banaszak, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2006-01968 Issued in NC

Practice address

101 Heart Drive
Ecu Physicians Family Medicine
Greenville, NC 27834

Phone

(252) 744-4611

Fax

(252) 744-3201

NPI assigned

Jan 2, 2007

Last updated

Apr 18, 2012By 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 1

Addresses

Other identifiers 2

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1356408272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HEART DRIVE",
            "address_2": "ECU PHYSICIANS FAMILY MEDICINE",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27834",
            "telephone_number": "252-744-4611",
            "fax_number": "252-744-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANASZAK",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2006-01968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "1464R",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909976",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Somasekhara R Balla, MD
• William A Ballance Jr., M.D.
• Alyssa Lauren Ballestero, FNP-C
• Maria Isabel Baltar de Barros Rego, DMD
• Richard J Baltaro, M.D.
• Kimberly Ann Bancale, M.S. CCC SLP
• Amanda Bandy
• Susan Bane, MD
• Prarthana Bangalore Parthasarathy
• Elizabeth C Banks, PHD

• Family Medicine Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.