MR. CHRISTOPHER JOSEPH BANTA (NPI# 1164545877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164545877 |
| Entity Type | Individual |
| Full Name | MR. CHRISTOPHER JOSEPH BANTA |
| Credential | BA PSYCHOLOGY |
| Practice Address |
218 Dividend Dr Ste 3 Rexburg ID 83440-3510 |
| Mailing Address |
635 Angela Dr Rexburg ID 83440-1422 |
| Practice Telephone | 2083599683 |
| Mailing Telephone | 2083510149 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers |
| Street Address |
218 DIVIDEND DR STE 3 |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-3510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639292626 | Ostermiller Counseling Services Inc. | Clinic/Center | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2007-04-06 |
| 1225397102 | Beth Winegar | Counselor | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2012-05-11 |
| 1477882025 | Benjamin Rolph | Counselor | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2009-12-10 |
| 1467675975 | Kory David Wilson | Counselor | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2007-04-11 |
| 1356464655 | Rodney Lee Sparks | Social Worker | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2007-04-10 |
| 1053434704 | Travis Paul Schwab | Counselor | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2007-04-09 |
| 1174646749 | Nathan Daniel Jensen | Social Worker | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2007-04-09 |
| 1396868691 | Jon Burnham | Social Worker | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2007-04-09 |
| 1134242712 | Kirk Lynn Mace | Social Worker | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2007-04-09 |
| 1336262898 | Kevin Allen Galbraith | Counselor | 218 Dividend Dr Ste 3, Rexburg, ID 83440-3510 | 2007-04-09 |
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| 1952956906 | Shane Ellis Withers | Pharmacist | 164 E. Main, Rexburg, ID 83440 | 2019-08-06 |
| 1316392285 | Emma Anderson | Speech-Language Pathologist | 36 Professional Plaza Suite 110, Rexburg, ID 83440 | 2016-04-28 |
| 1851755524 | Sandra Frickey | Speech-Language Pathologist | 1087 Summers Drive, Premier Therapy Associates, Rexburg, ID 83440 | 2016-04-08 |
| 1275997215 | Kerry Denney | Counselor | 333 Walker Drive, Rexburg, ID 83440 | 2016-04-06 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1649692609 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 410 W 1st N, Rexburg, ID 83440 | 2014-01-10 |
| 1043652571 | Creed Simon Webster | Counselor | 30 S 2nd W, Rexburg, ID 83440 | 2013-07-25 |
| 1033461660 | James Cannon Allen Dds PC | Dentist | 106 E 1st North, Rexburg, ID 83440 | 2012-10-05 |
| 1417217316 | Shelby Dee Woolstenhulme | Speech-Language Pathologist | 450 E. Main Street, Rexburg, ID 83440 | 2012-05-24 |
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| Taxonomy Code | 103TR0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376160820 | Mind Matters LLC | Psychologist | 8382 N Wayne Dr Ste 103b, Hayden, ID 83835-6028 | 2020-07-01 |
| 1003392598 | Joshua Welz | Psychologist | 3211 N Guinness Ln Apt 201, Post Falls, ID 83854 | 2018-07-17 |
| 1780061507 | Frank Howe | Psychologist | 167 North 4th East, Downey, ID 83234-0282 | 2015-04-30 |
| 1124454509 | Carlos Williams | Psychologist | 4696 W Overland Rd Ste 252, Boise, ID 83705-2877 | 2013-09-18 |
| 1528400793 | Marilyn Standfield | Psychologist | 1202 E 25th St, Idaho Falls, ID 83404-7072 | 2013-07-29 |
| 1467702829 | Rick N. Ho Chee | Psychologist | 2466 Addison Ave. East, Twin Falls, ID 83301 | 2012-09-13 |
| 1932454642 | Adolpho Enterprise LLC. | Psychologist | 2847 Hidden Hutch, Ammon, ID 83401-6036 | 2012-07-18 |
| 1174833966 | Kimberly Sue Kelly | Psychologist | 630 S Woodruff Ave, Idaho Falls, ID 83401-5299 | 2010-10-14 |
| 1821207580 | Firm Fouindations LLC | Psychologist | 2496 Mesa St, Idaho Falls, ID 83401-3369 | 2007-05-21 |
| 1427170133 | Pro Active Advantage, LLC | Psychologist | 264 Main Ave S, Twin Falls, ID 83301-6232 | 2007-04-04 |
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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.