Individual provider Active NPI

Evelyn R. Banks, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Saint Louis, MO
National Provider Identifier
1740288877
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0101042456 Issued in VA
Practice address
1563 Foxleigh CT
Saint Louis, MO 63131-1229
Phone
(314) 580-4207
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 0101042456 VA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101042456 VA Primary

Addresses

Primary practice location

1563 Foxleigh CT
Saint Louis, MO 63131-1229

Mailing address

1563 Foxleigh CT
Saint Louis, MO 63131-1229
Phone (314) 580-4207

Other identifiers 1

IdentifierTypeStateIssuer
006602703MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070213000037 MO Practitioner - Pathology 6901826312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
JC Edwards School of Medicine, Marshall University, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates PCGroup PAC ID 9436135860, 8 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-4768

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Pathology Group, Inc. Cytopathology CurrentSince Mar 1, 2007 Accepting new patients
Missouri Baptist Medical Center Current Accepting new patients
Parkway Pathology Group Cytopathology Past Accepting new patients
SSM Health Care St. Louis Cytopathology Past Accepting new patients

Locations

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

751 Sappington Bridge Rd
Sullivan, MO 63080
Phone (573) 468-1343

Organizations & group practices 5

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 3

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1740288877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 FOXLEIGH CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311229",
            "telephone_number": "314-580-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 FOXLEIGH CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311229",
            "telephone_number": "314-580-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "EVELYN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "VA",
            "license": "0101042456",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101042456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006602703",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.