Active NPI
Joann Marie Banik, RD, LDN
- Registered Dietitian
- Wellsboro, PA
National Provider Identifier
1568639151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN000873
- Practice address
- 14 Woodland Ave
Wellsboro, PA 16901-1907 - Phone
- (570) 724-5998
- NPI assigned
- May 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN000873 | PA | Primary |
Addresses
Primary practice location
14 Woodland Ave
Wellsboro, PA 16901-1907
Mailing address
14 Woodland Ave
Wellsboro, PA 16901-1907
Phone (570) 724-5998
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101530971 | Other | PA | PROMISE |
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 |
|---|---|---|---|
| DN000873 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1568639151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 WOODLAND AVE",
"city": "WELLSBORO",
"state": "PA",
"postal_code": "169011907",
"telephone_number": "570-724-5998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 WOODLAND AVE",
"city": "WELLSBORO",
"state": "PA",
"postal_code": "169011907",
"telephone_number": "570-724-5998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANIK",
"first_name": "JOANN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN000873",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROMISE",
"identifier": "101530971",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wellsboro, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.