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

Mr. Kenneth John Bannon, BSPA-C

Individual provider Physician Assistant · NPI 1821055047

Mr. Kenneth John Bannon, BSPA-C is a Physician Assistant in Carbondale, Pennsylvania. Qualified in 1986, 40 years ago. Practices with Delaware Center for Digestive Care LLC, a 69-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
40
Licensed in
PA
In the registry since
2006

Practice location Address checks out

111 Salem Ave Ste 302
Carbondale, PA 18407-2574
Phone: (570) 282-2031
Fax: (570) 282-2534
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA001023L (PA)

Record details

NPI number1821055047
Entity typeIndividual (Type 1)
GenderMale
Credentials BSPA-C
Sole proprietorNo
NPI enumeratedMay 1, 2006
Last updated in NPPESMarch 23, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Group practice Delaware Center For Digestive Care Llc — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Carbondale