Individual provider Active NPI

Stephanie A. Coursen-Bannister, D.C.

  • Chiropractor
  • Erie, PA
National Provider Identifier
1144226044
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007386L Issued in PA
Practice address
3441 Peach St
Erie, PA 16508-2739
Phone
(814) 864-2225
Fax
(814) 868-1199
NPI assigned
Jun 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC007386L PA Primary

Addresses

Primary practice location

3441 Peach St
Erie, PA 16508-2739

Mailing address

3441 Peach St
Erie, PA 16508-2739
Phone (814) 864-2225

Other identifiers 1

IdentifierTypeStateIssuer
0007853650001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000393 PA Practitioner - Chiropractic 2860526340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neck and Back Center of Erie, LLCGroup PAC ID 3375055742, 2 clinicians

Practice addresses (Care Compare)

3441 Peach St
Erie, PA 16508-2794
Phone (814) 864-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neck and Back Center of Erie, LLC Chiropractor CurrentSince Mar 23, 2025 Accepting new patients

Locations

3441 Peach St
Erie, PA 16508
Phone (814) 864-2225

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1144226044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082739",
            "telephone_number": "814-864-2225",
            "fax_number": "814-868-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082739",
            "telephone_number": "814-864-2225",
            "fax_number": "814-868-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURSEN-BANNISTER",
        "first_name": "STEPHANIE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007386L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007853650001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.