Individual provider Active NPI

Shelby Anne Banner, PHARMD

  • Pharmacist
  • Elizabethton, TN
National Provider Identifier
1699389585
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
44233 Issued in TN
Practice address
214 Broad St
Elizabethton, TN 37643-2714
Phone
(423) 547-2733
NPI assigned
Sep 8, 2020
Last updated
Sep 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 44233 TN Primary

Addresses

Primary practice location

214 Broad St
Elizabethton, TN 37643-2714

Mailing address

214 Broad St
Elizabethton, TN 37643-2714
Phone (423) 547-2733

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
44233TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Feb 24, 2022 Accepting new patients
Walgreen Co PastSince Sep 13, 2020 Accepting new patients

Locations

214 Broad St
Elizabethton, TN 37643
Phone (423) 547-2733

Organizations & group practices 2

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1699389585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BROAD ST",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432714",
            "telephone_number": "423-547-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BROAD ST",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432714",
            "telephone_number": "423-547-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNER",
        "first_name": "SHELBY",
        "middle_name": "ANNE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "44233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.