Individual provider Active NPI

David Alan Bannister, D.C.

  • Chiropractor
  • Fairmont, WV
National Provider Identifier
1730658105
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1031 Issued in WV
Practice address
220 Virginia Ave
Fairmont, WV 26554-0175
Phone
(304) 363-4134
Fax
(304) 333-2054
NPI assigned
Nov 15, 2018
Last updated
Nov 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1031 WV Primary

Addresses

Primary practice location

220 Virginia Ave
Fairmont, WV 26554-0175

Mailing address

220 Virginia Ave
Fairmont, WV 26554-0175
Phone (304) 363-4134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190430002002 WV Practitioner - Chiropractic 3577805118 Reassigns benefits to 1 organization
Practice locations: Fairmont, WV

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

220 Virginia Ave
Fairmont, WV 26554-0175
Phone (304) 363-4134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Monongahela Valley Association of Health Centers, Inc. CurrentSince Jun 18, 2025 Accepting new patients
David a Bannister Jr Chiropractor CurrentSince Apr 1, 2019 Accepting new patients
Monongahela Valley Association of Health Centers, Inc CurrentSince Jun 18, 2025 Accepting new patients

Locations

1322 Locust Ave
Fairmont, WV 26554
Phone (304) 366-0700

220 Virginia Ave
Fairmont, WV 26554
Phone (304) 363-4134

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1730658105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 VIRGINIA AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265540175",
            "telephone_number": "304-363-4134",
            "fax_number": "304-333-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 VIRGINIA AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265540175",
            "telephone_number": "304-363-4134",
            "fax_number": "304-333-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "1031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.

Verify at the official NPI Registry.