Laurent Graham Bannock, DHSC LN

Primary specialty

NutritionistTaxonomy code 133N00000X

License

P-0037 Issued in NM

Practice address

3600 Cerrillos Rd
Suite 207C
Santa Fe, NM 87507-2612

Phone

(505) 982-8475

Fax

(505) 989-7865

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952411092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CERRADO DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875088234",
            "telephone_number": "505-310-1476",
            "fax_number": "505-982-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 CERRILLOS RD",
            "address_2": "SUITE 207C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875072612",
            "telephone_number": "505-982-8475",
            "fax_number": "505-989-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNOCK",
        "first_name": "LAURENT",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "DHSC LN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NM",
            "license": "P-0037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorri Ballard, LPCC
• Rosalie Baltes, FSS
• Mollie Ban
• Brisa Banda
• Myles Banfors, BMS
• Araceli Banuelos
• Rebecca Banuelos
• Christine Patricia Baranowski, D.C.
• Jacob Leonard Barba Sr.
• Sarah Barba, LCSW

• Nutritionist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Nutritionist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.