Becka I Bannon, PA
Individual provider Active NPI Physician Assistant · Crawfordsville, IN
NPI 1073038899 · NPPES record last updated Jun 29, 2021
Key facts
- NPI
- 1073038899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 10002274A (IN)
- Practice address
- 4537 S Nucor Rd
Crawfordsville, IN 47933-7969 - Phone
- (765) 362-3579
- NPI assigned
- Aug 14, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170914002569 | IN | Practitioner - Physician Assistant | 6103190145 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10002274A | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hendricks County Hospital | Current |
Accepting new patients | |
| Mason Health Care LLC | Current |
Accepting new patients | |
| Hendricks County Hospital | Current |
Accepting new patients | |
| Hendricks County Hospital | Past | Accepting new patients | |
| Hendricks County Hospital | Past | Accepting new patients |
Locations
8244 E US Highway 36
Ste 1340
Avon, IN 46123
Phone (317) 520-5510
8244 E US Highway 36
Ste 1100
Avon, IN 46123
Phone (317) 272-7500
4537 S Nucor Rd
Crawfordsville, IN 47933
Phone (765) 362-3579
1000 E Main St
Danville, IN 46122
Phone (317) 745-3420
1100 Southfield Dr
Ste 1370
Plainfield, IN 46168
Phone (317) 837-5570
Interoperability endpoints
- https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
- bbannon334528@direct-prd.stelizabeth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10002274A | IN | Yes |
Addresses
Primary practice location
4537 S Nucor Rd
Crawfordsville, IN 47933-7969
Mailing address
4537 S Nucor Rd
Crawfordsville, IN 47933-7969
Phone (765) 362-3579
Other practice location 1
1000 E Main St
Danville, IN 46122-1948
Phone (317) 745-6139
Other practice location 2
8244 E US Highway 36 Ste 1100
Avon, IN 46123-9627
Phone (317) 272-7500
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bbannon334528@direct-PRD.stelizabeth.com | ||
| Other URL | becka.bannon@nucor.com |
Other providers in Crawfordsville, IN
- Athens Medical Group, Inc
- Athens Medical Group, Inc
- Athens Medical Group, LLC
- Atlantic Herring Inpatient Services LLC
- Matthew Joseph Bachman
- Saira Bano
- Aimee Elizabeth Barnett
- Jamie M Barton
- Matthew Barton
- Ravyn Batchelor
All providers in Crawfordsville, IN · Physician Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.