Logan Kale Banister, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1856 Issued in KS

Practice address

1626 E Madison Ave
Derby, KS 67037-2076

Phone

(316) 788-1535

Fax

(316) 788-1596

NPI assigned

Jul 16, 2009

Last updated

Aug 28, 2009By the provider in NPPES

Sex

Male

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 KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: loganbanisterod@derbyeye.direct.eyemdemr.com

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.

• Derby Eyecare LLC

  • Optometrist
  • Derby, KS
  • NPI 1134500101
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1154551828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 E MADISON AVE",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372076",
            "telephone_number": "316-788-1535",
            "fax_number": "316-788-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 E MADISON AVE",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372076",
            "telephone_number": "316-788-1535",
            "fax_number": "316-788-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANISTER",
        "first_name": "LOGAN",
        "middle_name": "KALE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azd Derby, LLC
• Bailey Holdings LLC
• Catherine I Baker, LMSW LSCSW
• Balance Behavioral Health LLC
• Aspen Joy Balthazor, DPT
• Thawab Barbour
• Cynthia Lynette Barger, CPM
• Carrie Lynn Barker, HHA
• Kathleen A Barrett, ARNP
• Jeffrey R Battiste, MPT

• Optometrist in Derby, KS
• Providers in Derby, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.
• 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.