Kimberley Yvonne Banta, LPC is a medicare enrolled "Counselor - Mental Health" provider in Ft Eisenhower, Georgia. Her current practice location is
300 W Hospital Rd, Ft Eisenhower, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 787-8656.
Kimberley Yvonne Banta is licensed to practice in Georgia (license number LPC010936) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1811548803.
Healthcare Provider's Profile
Full Name | Kimberley Yvonne Banta |
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Gender | Female |
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Speciality | Counselor - Mental Health |
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Location | 300 W Hospital Rd, Ft Eisenhower, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1811548803
- Provider Enumeration Date: 09/22/2019
- Last Update Date: 12/20/2023
Medicare PECOS Information:
- PECOS PAC ID: 7315475712
- Enrollment ID: I20250113003501
Medical Identifiers
Medical identifiers for Kimberley Yvonne Banta such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811548803 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | LPC010936 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberley Yvonne Banta allows following entities to bill medicare on her behalf.
Entity Name | Inpatient Psychology Solutions Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497383152 PECOS PAC ID: 2961825872 Enrollment ID: O20200710002283 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberley Yvonne Banta is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kimberley Yvonne Banta, LPC 3994 Madison Ln, Augusta, GA 30909-9215 Ph: (706) 836-2649 | Kimberley Yvonne Banta, LPC 300 W Hospital Rd, Ft Eisenhower, GA 30905-5741 Ph: (706) 787-8656 |
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