Individual provider Active NPI

Alan S Banks, DPM

  • Podiatrist
  • Atlanta, GA
National Provider Identifier
1639191646
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
545 Issued in GA
Practice address
2295 Parklake Dr NE
Suite 150
Atlanta, GA 30345-2825
Phone
(770) 938-5974
Fax
(770) 939-7393
NPI assigned
Jul 25, 2006
Last updated
May 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 545 GA Primary

Addresses

Primary practice location

2295 Parklake Dr NE
Suite 150
Atlanta, GA 30345-2825

Mailing address

4101 Charlotte Ave Ste F185
Nashville, TN 37209-4066
Phone (678) 426-2171

Other identifiers 5

IdentifierTypeStateIssuer
000356771DMedicaidGA
518114OtherAETNA
048552OtherBLUE CROSS
480018110OtherMCR RAILROAD
P00370534OtherGARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070320000426 GA Practitioner - Podiatry 3971606039 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
545GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Podiatry Group, L.L.C. Podiatrist CurrentSince Feb 1, 2007 Accepting new patients
Village Podiatry Group LLC Podiatrist CurrentSince Feb 1, 2007 Accepting new patients
Peachtree Podiatry Group Podiatrist Past Accepting new patients

Locations

2295 Parklake Dr NE
Ste 150
Atlanta, GA 30345
Phone (770) 938-5974

900 Circle 75 Pkwy SE
Ste 900
Atlanta, GA 30339
Phone (678) 426-2171

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

3655 Howell Ferry Rd
Ste 100
Duluth, GA 30096
Phone (770) 497-8283

3415 Holcomb Bridge Rd
Norcross, GA 30092
Phone (770) 449-1122

1357 Hembree Rd
Ste 100
Roswell, GA 30076
Phone (678) 990-9851

2193 Northlake Pkwy
Bldg 114
Tucker, GA 30084
Phone (770) 938-5974

4101 Charlotte Ave
Ste F185
Nashville, TN 37209
Phone (678) 426-2171

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1639191646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 CHARLOTTE AVE STE F185",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372094066",
            "telephone_number": "678-426-2171",
            "fax_number": "615-269-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 PARKLAKE DR NE",
            "address_2": "SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452825",
            "telephone_number": "770-938-5974",
            "fax_number": "770-939-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "ALAN",
        "middle_name": "S",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000356771D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "518114",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "048552",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RAILROAD",
            "identifier": "480018110",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00370534",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.