Kellie Audra Banfield, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

805 Davis St
Evanston, IL 60201-4401

Phone

(847) 864-1535

Fax

(847) 864-1537

NPI assigned

Nov 19, 2012

Last updated

Apr 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacer Physical Therapy, Inc.Group PAC ID 0244393429, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Pacer Physical Therapy, Inc.

  • Specialist
  • Walnut Creek, CA
  • NPI 1265685820

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Pacer Physical Therapy, Inc.

  • Specialist
  • San Ramon, CA
  • NPI 1568615979
  NPD

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1093059743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 DAVIS ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014401",
            "telephone_number": "847-864-1535",
            "fax_number": "847-864-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANFIELD",
        "first_name": "KELLIE",
        "middle_name": "AUDRA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Balanced Health
• Nikolas John Balasis
• Audrey Mutz Baldauf, CRNA
• Paris Jetaun Ball, PHD
• Amory S Balucating, MS, CCRN, CRNA, APN
• Angela Banks-Stewart, CCC-SLP
• Landan James Banks, MD
• Grace C Banner, M.D.
• Dhruv Bansal, MD
• Serena M. Baqai, D.O.

• Physical Therapist in Evanston, IL
• Providers in Evanston, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.