Organization Active NPI

Tristate Banp, LLC

  • Nurse Practitioner
  • Union, KY
National Provider Identifier
1720648850
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
TRISTATE BANP, LLC
Practice address
5032 Loch Dr
Union, KY 41091-1485
Phone
(859) 640-3627
NPI assigned
Jun 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Mrs. Lisa Arehart, APRNNPI 1730116823
Title
Owner
Phone
(859) 640-3627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

5032 Loch Dr
Union, KY 41091-1485

Mailing address

PO Box 131
Union, KY 41091-0131
Phone (859) 640-3627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190725002446 KY Part B Supplier - Clinic/Group Practice 2163758368 Receives reassigned benefits from 3 practitioners
Practice locations: Union, KY

National Provider Directory

National Provider Directory

Locations

16 Shelby St
Florence, KY 41042
Phone (859) 816-4585

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1720648850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410910131",
            "telephone_number": "859-640-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5032 LOCH DR",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410911485",
            "telephone_number": "859-640-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTATE BANP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-20",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "AREHART",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-640-3627",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.