Jasper S Banzon, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1092 Issued in WV

Practice address

1313 Dunbar Ave
Dunbar, WV 25064-2920

Phone

(304) 654-6892

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dunbar Physical Therapy LLCGroup PAC ID 4981047891, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Locations

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.

• Dunbar Physical Therapy LLC

  • Rehabilitation Clinic/Center
  • Dunbar, WV
  • NPI 1063198851
  Medicare reassignment Care Compare group NPD Authorized official
• Dunbar Therapy Center, LLC

  • Rehabilitation Clinic/Center
  • Dunbar, WV
  • NPI 1508291477
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1730200601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 398",
            "address_2": "5585 MADISON CREEK RD.",
            "city": "SALT ROCK",
            "state": "WV",
            "postal_code": "25559",
            "telephone_number": "304-654-6892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 DUNBAR AVE",
            "city": "DUNBAR",
            "state": "WV",
            "postal_code": "250642920",
            "telephone_number": "304-654-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANZON",
        "first_name": "JASPER",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY LIC",
            "identifier": "1092",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY LIC",
            "identifier": "KY-R2967",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Bady
• Betty Bailey
• Lisa Bailey
• Jessica Baisden, PHARMD
• Teresa Banks
• Stacie Banzon
• Connie Barr
• Kelli Batch
• David Edward Beaver, D.D.S.
• Casey Ryan Belcher

• Occupational Therapist in Dunbar, WV
• Providers in Dunbar, WV by specialty
• Occupational Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.