Individual provider Active NPI

Eryn Ann Bannister, DPT

  • Orthopedic Physical Therapist
  • San Diego, CA
National Provider Identifier
1801124102
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT35428 Issued in CA
Practice address
5677 Oberlin Dr
Suite #106
San Diego, CA 92121-1740
Phone
(858) 457-8419
Fax
(858) 457-0670
NPI assigned
Nov 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT35428 CA Primary

Addresses

Primary practice location

5677 Oberlin Dr
Suite #106
San Diego, CA 92121-1740

Mailing address

5677 Oberlin Dr
Suite #106
San Diego, CA 92121-1740
Phone (858) 457-8419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT35428CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Angela Yvonne Acupuncture Inc Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Comprehensive Therapy Services, Inc. Orthopedic PastSince Jul 27, 2007 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1801124102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5677 OBERLIN DR",
            "address_2": "SUITE #106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211740",
            "telephone_number": "858-457-8419",
            "fax_number": "858-457-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5677 OBERLIN DR",
            "address_2": "SUITE #106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211740",
            "telephone_number": "858-457-8419",
            "fax_number": "858-457-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "ERYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT35428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.