Individual provider Active NPI

Rachelle Banning, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dodge City, KS
National Provider Identifier
1083468391
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
53-84150-091 Issued in KS
Practice address
2012 1St Ave Ste B
Dodge City, KS 67801-2665
Phone
(620) 207-1321
Fax
(620) 202-6757
NPI assigned
Apr 15, 2024
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 53-84150-091 KS Primary
Registered Nurse 163W00000X 136521 KS

Addresses

Primary practice location

2012 1St Ave Ste B
Dodge City, KS 67801-2665

Mailing address

2012 1St Ave Ste B
Dodge City, KS 67801-2665
Phone (620) 207-1321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305000993 KS Practitioner - Nurse Practitioner 5597247833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2601 Central Ave
Suite LL22
Dodge City, KS 67801-6223
Phone (620) 255-9706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
136521KSMDRegistered Nurse
53-84150-091KSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Up Mental Health Psychiatric/Mental Health CurrentSince Jan 3, 2026 Accepting new patients

Locations

2012 1st Ave
Ste B
Dodge City, KS 67801
Phone (620) 207-1321

2601 Central Ave
Ste LL22
Dodge City, KS 67801
Phone (620) 255-9706

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1083468391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 1ST AVE STE B",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012665",
            "telephone_number": "620-207-1321",
            "fax_number": "620-202-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 1ST AVE STE B",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012665",
            "telephone_number": "620-207-1321",
            "fax_number": "620-202-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNING",
        "first_name": "RACHELLE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-84150-091",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "136521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

Verify at the official NPI Registry.