Roger James Bannon, OTR, CHT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

OT002316 Issued in GA

Practice address

3645 Gentian Blvd
Suite 1
Columbus, GA 31907-5687

Phone

(706) 507-4433

NPI assigned

Dec 16, 2009

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

Other names 1

• Roger James Koon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1447589767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 GENTIAN BLVD",
            "address_2": "SUITE 1",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319075687",
            "telephone_number": "706-507-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 GENTIAN BLVD",
            "address_2": "SUITE 1",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319075687",
            "telephone_number": "706-507-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNON",
        "first_name": "ROGER",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "OTR, CHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "GA",
            "license": "OT002316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROGER",
            "last_name": "KOON",
            "middle_name": "JAMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Latisha Banks
• Meredith Banks, FNP-C
• Patrick Banks
• Wanda Banks
• Faith Bankston
• Wendy Elizabeth Barb
• Leigh Ann Barbaree, NP
• Melissa Denise Barbee
• Denisha Marie Barber, LMSW
• Kiana Barclift

• Hand Occupational Therapist in Columbus, GA
• Providers in Columbus, GA by specialty
• Hand Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.