Michele L. Bannister, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11015678 Issued in FL

Practice address

930 Kingsley Ave
Orange Park, FL 32073-4704

Phone

(904) 269-0500

NPI assigned

Mar 30, 2020

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

James M Grimes Orthopaedics LLCGroup PAC ID 3779976584, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbannister7819@direct.shands.ufl.edu

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.

• James M Grimes Orthopaedics LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • St Augustine, FL
  • NPI 1598424699
  Medicare reassignment Care Compare group
• One Med Inc.

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1730059908
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • St Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1669000105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734704",
            "telephone_number": "904-269-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734704",
            "telephone_number": "904-269-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "MICHELE",
        "middle_name": "L.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11015678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthi Balasubramaniam, DO
• Natallia Michailovna Baldev, CRNA
• Shari Daniela Baldwin
• Melissa Marie Ballard-Martin, A.P.R.N.
• Mohamad Amir Balloura, MD
• Baptist Cardiology Inc (Baptist Heart Specialists)
• Baptist Health Clinic Inc
• Baptist Primary Care
• Baptist Primary Care Inc
• Baptist Primary Care Inc

• Family Nurse Practitioner in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.