Brain Bantum (NPI# 1578735999, PAC ID# 5496901092) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1578735999 |
| PAC ID by PECOS | 5496901092 |
| Professional Enrollment ID | I20120815000167 |
| Full Name | Brain Bantum |
| Organization Legal Name | SILVER STATE SPINECARE FORREST BURKE MD A PROFESSIONAL CORP. |
| Address |
1055 Roberta Ln Suite 103 Sparks NV 89431-2821 |
| Phone Number | 7753312600 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Secondary Specialties | INTERVENTIONAL PAIN MANAGEMENT |
| Group Practice PAC ID | 4981623378 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 290049 | RENOWN SOUTH MEADOWS MEDICAL CENTER |
| 290001 | RENOWN REGIONAL MEDICAL CENTER |
| 290032 | NORTHERN NEVADA MEDICAL CENTER |
| 291313 | BANNER CHURCHILL COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1055 Roberta Ln, Suite 103, Sparks, NV 89431-2821 | 7753312600 | SILVER STATE SPINECARE FORREST BURKE MD A PROFESSIONAL CORP. |
| Organization Legal Name | SILVER STATE SPINECARE FORREST BURKE MD A PROFESSIONAL CORP. |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrea Tatro | Physical Medicine and Rehabilitation | Silver State Spinecare Forrest Burke Md A Professional Corp. | 1055 Roberta Ln, Suite 103, Sparks, NV 89431-2821 |
| Brian F Burke | Physical Medicine and Rehabilitation | Silver State Spinecare Forrest Burke Md A Professional Corp. | 1055 Roberta Ln, Suite 103, Sparks, NV 89431-2821 |
| Street Address |
1055 ROBERTA LN SUITE 103 |
| City | SPARKS |
| State | NV |
| Zip | 89431-2821 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrea Tatro | Physical Medicine and Rehabilitation | Silver State Spinecare Forrest Burke Md A Professional Corp. | 1055 Roberta Ln, Suite 103, Sparks, NV 89431-2821 |
| Brian F Burke | Physical Medicine and Rehabilitation | Silver State Spinecare Forrest Burke Md A Professional Corp. | 1055 Roberta Ln, Suite 103, Sparks, NV 89431-2821 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dale E Grensted | Chiropractic | 1105 Rock Blvd, Sparks, NV 89431-0933 | |
| Warren J Whitley | Optometry | Paul W Hiss Md Ltd | 2285 Green Vista Dr, Sparks, NV 89431-1071 |
| Mackenzie Macintyre Iii | Optometry | Paul W Hiss Md Ltd | 2285 Green Vista Dr, Sparks, NV 89431-1071 |
| Curtis A Manning | Ophthalmology | Paul W Hiss Md Ltd | 2285 Green Vista Dr, Sparks, NV 89431-1071 |
| Paul W Hiss | Ophthalmology | Paul W Hiss Md Ltd | 2285 Green Vista Dr, Sparks, NV 89431-1071 |
| Douglas K Devries | Optometry | Paul W Hiss Md Ltd | 2285 Green Vista Dr, Sparks, NV 89431-1071 |
| Fanny W Chan | Optometry | 738 Prater Way, Sparks, NV 89431-1888 | |
| Julia L Miller | Chiropractic | 2351 Pyramid Way, Suite 24, Sparks, NV 89431-2163 | |
| Lige A Lambeth | Chiropractic | 1855 Sullivan Ln, Suite 125, Sparks, NV 89431-2851 | |
| Monica M Moreland | Physical Therapy | Moreland Physical Therapy Prof. Corp. | 2225 N Mccarran Blvd, Sparks, NV 89431-3365 |
| Find all physicians in zip 89431 | |||
| City | SPARKS |
| Zip Code | 89431 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | SPARKS + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Brain Bantum.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.