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

Individual provider Obstetrics & Gynecology Physician · NPI 1962065219

Kaitlyn R Banning is an Obstetrics/Gynecology in Prescott, Arizona. Graduated from Philadelphia Col of Osteo Med, Sewanee in 2019, 7 years ago. Practices with Genesis OB GYN PLLC, a 108-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona and Michigan.

Years since qualifying
7
Trained at
Philadelphia Col of Osteo Med, Sewanee
Licensed in
AZ, MI
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

1005 Division St
Prescott, AZ 86301-1601
Phone: (928) 776-8428
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3990 John R St, Detroit, MI 48201-2018 — (313) 993-4030

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 011238 (AZ)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 5101027374 (MI)

Record details

NPI number1962065219
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 22, 2019
Last updated in NPPESDecember 3, 2024
Certification dateDecember 3, 2024
Mailing address1005 Division St, Prescott, AZ 86301-1601

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Also practisesGYNECOLOGICAL ONCOLOGY
Medical schoolPHILADELPHIA COL OF OSTEO MED, SEWANEE
Graduated 2019 (7 years in practice)
Group practice Genesis Ob Gyn Pllc — 108 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Prescott