Thomas G Bannister, MD
Individual provider Active NPI Psychiatry Physician · Memphis, TN
NPI 1881701985 · NPPES record last updated Jan 16, 2009
Key facts
- NPI
- 1881701985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 25198 (TN)
- Practice address
- 5384 Poplar Ave
Suite 106
Memphis, TN 38119-3609 - Phone
- (901) 255-3030
- Fax
- (901) 507-7811
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25198 | TN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Medicine Consultants, PLLC | Psychiatry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25198 | TN | Yes |
Addresses
Primary practice location
5384 Poplar Ave
Suite 106
Memphis, TN 38119-3609
Mailing address
5384 Poplar Ave
Suite 106
Memphis, TN 38119-3609
Phone (901) 255-3030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3081700 | Medicaid | TN |
Other providers in Memphis, TN
- Jessica Renee Banks
- Margaret Banks
- Shadonna Roshawn Banks
- Tovia Banks
- Lea Mary Bannister
- Ferdinand Bantilan
- Qiping Bao
- Baptist Cancer Center Physicians Foundation, Inc.
- Baptist Memorial Health Services Inc
- Baptist Memorial Health Services Inc
All providers in Memphis, TN · Psychiatry Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.