Jean Michelle Bannick, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103792 Issued in MN

Practice address

7900 W 28TH St
St Louis Park, MN 55426-3011

Phone

(651) 698-0830

NPI assigned

Dec 19, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Center for Speech, Language, and Learning, Inc.

  • Hearing and Speech Clinic/Center
  • Oakdale, MN
  • NPI 1588592471
  NPD (past)

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

{
    "created_epoch": "1261180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261180800000",
    "number": "1407185523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 W 28TH ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263011",
            "telephone_number": "651-698-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W 28TH ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263011",
            "telephone_number": "651-698-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNICK",
        "first_name": "JEAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-19",
        "last_updated": "2009-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Banal, LICSW
• Matthew Banfield, MD
• Bilikisu Banjoko, MA, LMFT
• Olufemi O Banjoko, MD
• Georgia Banks
• David A Barlow, PA-C
• Jack Barlow
• Rebecca Anne Barnack, NP
• Ashley Ann Barnes, RD,MS
• Erin Barnes, RD

• Occupational Therapist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2009; 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.