NPIMap

Kimary Lee-Banks, AGPCNP - BC

Individual provider Active NPI Gerontology Nurse Practitioner · Memphis, TN

NPI 1689189698 · NPPES record last updated Jan 17, 2024

Key facts

NPI
1689189698
Entity type
Individual (NPI type 1)
Primary specialty
Gerontology Nurse Practitioner 363LG0600X
License
23681 (TN)
Practice address
360 E Eh Crump Blvd
Memphis, TN 38126-5394
Phone
(901) 261-2000
NPI assigned
Dec 13, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 16

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.

Hospital & facility affiliations 4

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

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christ Community Health Services Inc. (61 clinicians)

Practice addresses (Care Compare)

2569 Douglas Ave
Memphis, TN 38114-2532
Phone (901) 271-6200

2861 Broad Ave
Memphis, TN 38112-2903
Phone (901) 842-3168

3362 S 3Rd St
Memphis, TN 38109-2944
Phone (901) 271-6300

3481 Austin Peay Hwy
Memphis, TN 38128-3801
Phone (901) 701-2570

5366 Mendenhall Mall
Memphis, TN 38115-4505
Phone (901) 271-6100

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital · Memphis, TN · CCN 440049
  • Baptist Memorial Hospital Hospital · Memphis, TN · CCN 440048

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190603000525 TN Practitioner - Nurse Practitioner 4082947262 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Health Center, Inc. Current
since Jun 26, 2023		 Accepting new patients
Christ Community Health Services Inc Current
since Nov 1, 2024		 Accepting new patients
Christ Community Health Services Inc Current
since Nov 1, 2024		 Accepting new patients
Memphis Health Center, Inc. Current
since Jun 26, 2023		 Accepting new patients
Christ Community Health Services Inc Current Accepting new patients
Christ Community Health Services Inc Past Accepting new patients

Locations

969 Frayser Blvd
Memphis, TN 38127
Phone (901) 260-8400

2670 Union Avenue Ext
Ste 1000
Memphis, TN 38112
Phone (901) 842-3160

360 E Eh Crump Blvd
Memphis, TN 38126
Phone (901) 261-2000

3362 S 3rd St
Memphis, TN 38109
Phone (901) 271-6300

3481 Austin Peay Hwy
Memphis, TN 38128
Phone (901) 701-2570

5366 Mendenhall Mall
Memphis, TN 38115
Phone (901) 271-6100

2861 Broad Ave
Memphis, TN 38112
Phone (901) 260-8500

1325 Jefferson Ave
Memphis, TN 38104
Phone (901) 701-2530

2569 Douglass Ave
Memphis, TN 38114
Phone (901) 271-6200

4940 Highway 57
Ste 107
Rossville, TN 38066
Phone (901) 261-2221

Interoperability endpoints

  • Direct secure messaging: kimary.lee-banks.1@20250.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 903682 MS
Gerontology Nurse Practitioner 363LG0600X 23681 TN Yes

Addresses

Primary practice location

360 E Eh Crump Blvd
Memphis, TN 38126-5394

Mailing address

360 E Eh Crump Blvd
Memphis, TN 38126-5394
Phone (901) 261-2000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 17, 2024.

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1689189698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265394",
            "telephone_number": "901-261-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265394",
            "telephone_number": "901-261-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-BANKS",
        "first_name": "KIMARY",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP - BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-13",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "903682",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "23681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

All providers in Memphis, TN · Gerontology Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.