Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kathleen Bannerman, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629652219

Dr. Kathleen Bannerman, MD is a Family Practice in Kingston, Pennsylvania. Qualified in 2018, 8 years ago. Practices with Phoenix Rehabilitation and Health Services Inc, a 2,720-clinician group, works from 6 locations, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
8
Licensed in
PA
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

560 Pierce St
Kingston, PA 18704-5716
Phone: (570) 283-2161
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 530 Centre St, Ashland, PA 17921-1330 — (570) 645-1670
  • 100 W Patterson St, Lansford, PA 18232-1304 — (272) 639-5020
  • 1254 Interchange Rd, Lehighton, PA 18235-9069 — (484) 426-2050
  • 411 S Shenandoah Rd, Ringtown, PA 17967-9432 — (570) 645-1951
  • 34 S Railroad St, Tamaqua, PA 18252-1927 — (570) 645-1950

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD485646 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence MT222612 (PA)

Record details

NPI number1629652219
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 10, 2021
Last updated in NPPESAugust 13, 2024
Certification dateAugust 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Phoenix Rehabilitation And Health Services Inc — 2720 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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