NPIMap

Individual provider Active NPI

Kathryn K Banner, MD

  • Internal Medicine Physician
  • Bristol, RI
National Provider Identifier
1417094061
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD12307 Issued in RI
Practice address
1180 Hope St
Bristol, RI 02809-1126
Phone
(401) 247-0610
Fax
(401) 253-3131
NPI assigned
Jan 31, 2007
Last updated
Dec 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD12307 RI Primary

Addresses

Primary practice location

1180 Hope St
Bristol, RI 02809-1126

Mailing address

1180 Hope St
Bristol, RI 02809-1126
Phone (401) 247-0610

Other identifiers 6

IdentifierTypeStateIssuer
050340866OtherRIUHC
AA89360OtherRIHARVARD PILGRIM
414090OtherRIBCHIP
0000032662OtherRIB/S
1417094MedicaidRI
32535OtherRINEIGHBORHOOD HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070711000705 RI Practitioner - Internal Medicine 0042310617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Ri, Inc.Group PAC ID 3375432040, 32 clinicians

Practice addresses (Care Compare)

1180 Hope St
Bristol, RI 02809-1126
Phone (401) 253-8900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Ri Inc Internal Medicine CurrentSince Jul 1, 2007 Accepting new patients
Medical Associates of Rhode Island Inc. Internal Medicine Past Accepting new patients

Locations

1180 Hope St
Bristol, RI 02809
Phone (401) 253-8900

Interoperability endpoints

  • Direct secure messaging: kathryn.banner@maori.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1417094061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 HOPE ST",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028091126",
            "telephone_number": "401-247-0610",
            "fax_number": "401-253-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 HOPE ST",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028091126",
            "telephone_number": "401-247-0610",
            "fax_number": "401-253-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNER",
        "first_name": "KATHRYN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD12307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "050340866",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA89360",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCHIP",
            "identifier": "414090",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/S",
            "identifier": "0000032662",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417094",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "32535",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, RI

Sources for this page

Verify at the official NPI Registry.