Kelly Nicole Banneyer, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

37690 Issued in TX

Practice address

6701 Fannin St Ste 1630
Houston, TX 77030-2615

Phone

(832) 822-3700

Fax

(832) 825-4164

NPI assigned

May 1, 2018

Sex

Female

Sole proprietor

No

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1104314533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST STE 1630",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302615",
            "telephone_number": "832-822-3700",
            "fax_number": "832-825-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST STE 1630",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302615",
            "telephone_number": "832-822-3700",
            "fax_number": "832-825-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNEYER",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "37690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bannack Dialysis LLC (Dairy Ashford Dialysis)
• Olivia Bannan, M.D.
• Barbara Jean Banner, MD
• Edward Arthur Banner, M.D.
• Katherine Alexis Banner
• Rohan Kendall Bannis, M.D.
• Brandy Bannister, D.D.S.
• Shawn K. Bannister, CRNA
• Sarah Bannon, MS, CGC
• Anjuly Bansal, PA

• Clinical Child & Adolescent Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Clinical Child & Adolescent Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.