Individual provider Active NPI

Katy Conway Ebert, O.D.

  • Optometrist
  • Salina, KS
National Provider Identifier
1386933554
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2214 Issued in MD
Practice address
1000 E Cloud St
Salina, KS 67401-6416
Phone
(785) 493-5389
NPI assigned
Mar 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2214 MD Primary

Addresses

Primary practice location

1000 E Cloud St
Salina, KS 67401-6416

Mailing address

2483 Saint Andrews LN
Salina, KS 67401-7133
Phone (785) 493-5389

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110926000897 KS Practitioner - Optometry 0941471841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS Cooper and Banninger LLCGroup PAC ID 9436166444, 4 clinicians

Practice addresses (Care Compare)

1000 E Cloud St
Salina, KS 67401-6416
Phone 7858236391228

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1892KSMDProfessional Counselor
TA2214MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Cooper & Banninger, LLC. Optometrist CurrentSince Aug 17, 2011 Accepting new patients
DRS. Cooper & Banninger, LLC. Optometrist Past Accepting new patients

Locations

112 W Main St
Beloit, KS 67420
Phone (785) 569-0202

119 W 7th St
Concordia, KS 66901
Phone (785) 243-2175

1000 E Cloud St
Salina, KS 67401
Phone (785) 493-5389

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1386933554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2483 SAINT ANDREWS LN",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674017133",
            "telephone_number": "785-493-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E CLOUD ST",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674016416",
            "telephone_number": "785-493-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "KATY",
        "middle_name": "CONWAY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

Verify at the official NPI Registry.