Individual provider Active NPI

Lacey Banther, LPN

  • Licensed Practical Nurse
  • Chattanooga, TN
National Provider Identifier
1609286376
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN-8275166 Issued in TN
Practice address
3074 Hickory Valley Rd
Chattanooga, TN 37421-1265
Phone
(423) 622-1551
NPI assigned
May 5, 2014
Last updated
May 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN-8275166 TN Primary

Addresses

Primary practice location

3074 Hickory Valley Rd
Chattanooga, TN 37421-1265

Mailing address

PO Box 8114
Chattanooga, TN 37414-0114

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN-8275166TNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1609286376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8114",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374140114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3074 HICKORY VALLEY RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211265",
            "telephone_number": "423-622-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTHER",
        "first_name": "LACEY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "LPN-8275166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.