Jack Bannin, LMFT, LPC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

5072 Issued in TX

Practice address

11230 West Ave Ste 1203
San Antonio, TX 78213-1359

Phone

(210) 320-2999

Fax

(210) 320-4716

NPI assigned

Aug 30, 2006

Last updated

May 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Care Center LLC,

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Round Rock, TX
  • NPI 1427786482
  Medicare reassignment NPD
• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288

  Professional

  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1902915861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15403 AIROLE WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324013",
            "telephone_number": "210-825-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11230 WEST AVE STE 1203",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131359",
            "telephone_number": "210-320-2999",
            "fax_number": "210-320-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNIN",
        "first_name": "JACK",
        "name_prefix": "Mr.",
        "credential": "LMFT, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "18744",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "5072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163782902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laiya Nichole Bankston
• Stephanie Bankston, PMHNP-BC
• Ireland Buckley Banner, MD
• Jenna Nicole Banner, MD
• Steven Banner, MD
• Shweta Bansal, MD
• Pabitra Banskota, DDS
• Swetha Reddy Banswada, M.D
• Linda J. Banta, M.D.
• Surbhi Banubakode

• Marriage & Family Therapist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.