Active NPI
Dan Bannister, LICSW
- Social Worker
- Burnsville, MN
National Provider Identifier
1447424403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LICSW4951
- Practice address
- 1523 Highway 13 E
Burnsville, MN 55337-2917 - Phone
- (952) 894-4828
- Fax
- (952) 894-3737
- NPI assigned
- Apr 21, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LICSW4951 | MN | Primary |
Addresses
Primary practice location
1523 Highway 13 E
Burnsville, MN 55337-2917
Mailing address
1523 Highway 13 E
Burnsville, MN 55337-2917
Phone (952) 894-4828
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICSW4951 | MN | MD | Social Worker |
| 4951 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208736000000",
"number": "1447424403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1523 HIGHWAY 13 E",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553372917",
"telephone_number": "952-894-4828",
"fax_number": "952-894-3737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1523 HIGHWAY 13 E",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553372917",
"telephone_number": "952-894-4828",
"fax_number": "952-894-3737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNISTER",
"first_name": "DAN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-21",
"last_updated": "2008-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "LICSW4951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.