Active NPI
Bryan Banuelos
- Ophthalmic Technician/Technologist
- Wichita, KS
National Provider Identifier
1144001579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Technician/Technologist
- License
- 276840
- Practice address
- 949 S Glendale St
Wichita, KS 67218-3210 - Phone
- (316) 685-2221
- Fax
- (316) 239-2747
- NPI assigned
- Oct 11, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Technician/Technologist | 156FX1100X | 276840 | Primary |
Addresses
Primary practice location
949 S Glendale St
Wichita, KS 67218-3210
Mailing address
237 W Hunter St
Derby, KS 67037-4105
Phone (316) 882-6035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696982400000",
"number": "1144001579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "237 W HUNTER ST",
"city": "DERBY",
"state": "KS",
"postal_code": "670374105",
"telephone_number": "316-882-6035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "949 S GLENDALE ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672183210",
"telephone_number": "316-685-2221",
"fax_number": "316-239-2747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANUELOS",
"first_name": "BRYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-11",
"last_updated": "2023-10-11",
"certification_date": "2023-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1100X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ophthalmic",
"state": null,
"license": "276840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.