Jonathan Philip Banks, PTA

Key facts

NPI

1881027951

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

License

A3856 (MD)

Practice address

300 Lemmon Hill LN
Salisbury, MD 21801-4239

Phone

(410) 334-3563

NPI assigned

Aug 13, 2013

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 13, 2013.

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1881027951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LEMMON HILL LN",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014239",
            "telephone_number": "410-334-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LEMMON HILL LN",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014239",
            "telephone_number": "410-334-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "JONATHAN",
        "middle_name": "PHILIP",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A3856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Salisbury, MD · Physical Therapy Assistant in Maryland