DALLAS BANNER (NPI# 1033763537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033763537 |
| Entity Type | Individual |
| Full Name | DALLAS BANNER |
| Credential | NP |
| Practice Address |
1023 Edgehill Rd S Charlotte NC 28207-1829 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7043558686 |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2020-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5012314 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Medical Park Dr, Ste 110, Concord, NC 280252948 | 7044036826 | |
| 1021 Morehead Medical Dr, Ste A, Charlotte, NC 282042990 | 9804422000 | |
| 1023 Edgehill Rd S, Charlotte, NC 282071829 | 7043558686 | |
| 1350 S Kings Dr, Charlotte, NC 282072134 | 7044461255 |
| Street Address |
1023 EDGEHILL RD S |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972542298 | Chris Teigland | Urology | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2006-06-05 |
| 1588272785 | Kathryn Barnes | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2020-07-14 |
| 1932739372 | Ava Opalinski | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2020-01-24 |
| 1326528548 | Marie Barkley | Physician Assistant | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2018-08-16 |
| 1679073332 | Abby Looper | Physician Assistant | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2018-02-19 |
| 1972920684 | Jamie Vano | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2014-03-20 |
| 1134558083 | Savanna Watkins | Physician Assistant | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2013-11-01 |
| 1265866990 | Jaclyn Mieczkowski | Nurse Practitioner | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2013-08-29 |
| 1598022089 | Maxim Mckibben | Urology | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2012-04-20 |
| 1558655936 | Manish Patel | Urology | 1023 Edgehill Rd S, Charlotte, NC 28207-1829 | 2011-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544986 | Tonya Lynn Burris | Nurse Practitioner | 7810 Providence Rd Ste 102, Charlotte, NC 28226-2987 | 2020-09-28 |
| 1003428293 | Kashari Davis | Nurse Practitioner | 4252 Sutwick Dr, Charlotte, NC 28269-6001 | 2020-08-19 |
| 1457972796 | Lindsey O'brien | Nurse Practitioner | 3423 Hornets Nest Way, Charlotte, NC 28208-5224 | 2020-04-28 |
| 1285254904 | Barbara Ballard | Nurse Practitioner | 10731 Haddington Dr Nw, Charlotte, NC 28269-6954 | 2020-04-22 |
| 1710506787 | Lindsey Delcasino Plair | Nurse Practitioner | 1212 South Blvd, Charlotte, NC 28203-4215 | 2020-04-10 |
| 1457991275 | Advanced Physical Medicine | Nurse Practitioner | 8821 University East Dr # 120, Charlotte, NC 28213-4200 | 2020-01-09 |
| 1700447562 | Milford Darnell George Jr. | Nurse Practitioner | 8403 University Executive Park Drive, Suite 685, Charlotte, NC 28262-3330 | 2019-06-24 |
| 1194288241 | Tonya Denise Farmer | Nurse Practitioner | 620 Tom Hunter Road, Charlotte, NC 28213 | 2019-04-06 |
| 1649738204 | Brittany Schmalfeld | Nurse Practitioner | 8943 S Tryon St Unit K, Charlotte, NC 28273-3539 | 2019-03-03 |
| 1407313703 | Natalie Ann Bullock | Nurse Practitioner | 400 E Stonewall St Ste F, Charlotte, NC 28202-3601 | 2019-02-23 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.