Keith M Banton MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME85024 Issued in FL

Legal business name

KEITH M BANTON MD PA

Practice address

3230 E 15TH St
Unit B
Panama City, FL 32405-7423

Phone

(850) 763-4700

Fax

(850) 763-4999

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Keith M Banton, M.D.

Title

President

Phone

(850) 763-4700

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15666/brand/1/csg/1/fhir/r4

Practitioners 2

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

• Keith B Banton, M.D.

  • Family Medicine Physician
  • Panama City, FL
  • NPI 1205896636
  Medicare reassignment NPD
• Destinee Bertia Blei, AGNP-C

  • Adult Health Nurse Practitioner
  • Panama City, FL
  • NPI 1346734324
  Medicare reassignment NPD

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1891887600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 E 15TH ST",
            "address_2": "UNIT B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057423",
            "telephone_number": "850-763-4700",
            "fax_number": "850-763-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 E 15TH ST",
            "address_2": "UNIT B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057423",
            "telephone_number": "850-763-4700",
            "fax_number": "850-763-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH M BANTON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "BANTON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-763-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME85024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265799600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "13636",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trami L Kaufman
• Cathrine Kivett Kearns, LCSW
• Ryan Keck, BCBA
• Adrienne Keely, NP-C
• Sara M Keene, CRNA
• Shelley Keller Clark, AG-ACNP
• Elizabeth Keller
• Joe Mac Keller, DDS MS
• Brandi Nichole Kelley
• Justin Patrick Kelley, CRNA

• Family Medicine Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.