NBK Enterprises, LLC

Key facts

NPI

1831789817

Entity type

Organization (NPI type 2)

Primary specialty

Primary Care Clinic/Center 261QP2300X

Legal business name

NBK ENTERPRISES, LLC

Practice address

61 Logan Street
Marion, NC 28752-2856

Phone

(828) 442-2845

NPI assigned

Jan 22, 2021

Organization subpart

No

Authorized official

Name

Kelli Banner, NP NPI 1598149775

Title

Owner

Phone

(828) 442-2845

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

Practitioners 4

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

• Kelli Banner, FNP-C Family Nurse Practitioner · Marion, NC · NPI 1598149775
  Medicare reassignment Care Compare group NPD Authorized official NC
• Kiersten Grayson Reid, FNP Family Nurse Practitioner · Marion, NC · NPI 1821833542
  Medicare reassignment Care Compare group NPD NC
• Ashley Rebecca Hendrixon-Ward Family Nurse Practitioner · Bakersville, NC · NPI 1447981212
  Medicare reassignment NPD NC
• Jordan Nicole Laughter, FNP-C Family Nurse Practitioner · Marion, NC · NPI 1427976125
  NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NC

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Marion Medical Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 15, 2024.

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1831789817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 BURMA RD W",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287525277",
            "telephone_number": "828-442-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 LOGAN STREET",
            "city": "MARION",
            "state": "NC",
            "postal_code": "287522856",
            "telephone_number": "828-442-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NBK ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-22",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "BANNER",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-442-2845",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marion Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, NC

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• Courtney Dawn Mull, MD
• Callie Ann Munson, LCMHC-A
• London Murray
• National Mentor Healthcare LLC
• Amber Nelon
• Christopher Thomas Nevant, D.D.S
• New Beginnings Alliance LLC
• New Destinations, Inc.
• New Destinations, Inc.

All providers in Marion, NC · Primary Care Clinic/Center in North Carolina