Active NPI
Kathryn Bangs, PHD
- School Psychologist
- Eldorado, IL
National Provider Identifier
1225599160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 1412 US Highway 45 N
Eldorado, IL 62930-3766 - Phone
- (618) 273-3326
- NPI assigned
- Mar 25, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
1412 US Highway 45 N
Eldorado, IL 62930-3766
Mailing address
1412 US Highway 45 N
Eldorado, IL 62930-3766
Phone (618) 273-3326
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260320002545 | IL | Practitioner - Psychologist Billing Independently | 9335623982 | Practice locations: Eldorado, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1412 US Hwy 45 N
Eldorado, IL 62930-3766
Phone (401) 261-9151
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1225599160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 US HIGHWAY 45 N",
"city": "ELDORADO",
"state": "IL",
"postal_code": "629303766",
"telephone_number": "618-273-3326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1412 US HIGHWAY 45 N",
"city": "ELDORADO",
"state": "IL",
"postal_code": "629303766",
"telephone_number": "618-273-3326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGS",
"first_name": "KATHRYN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-25",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eldorado, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.