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Deactivated NPI 1972974525 Deactivated / Inactive NPI Male Practitioner

Bake Thomas Bannister , PA-C

Physician Assistant • Borger, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Bake Bannister has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 08, 2015
NPI Deactivation Date February 23, 2017
Total Practice Duration ~2 Years of Practice (2015 – 2017)

Professional Overview & Biography Verified Profile Summary

Bake Bannister, PA-C was a registered Physician Assistant practicing in Borger, TX. Throughout an active medical career spanning 2 years, Bake Bannister provided care at the practice location at 104 N BRYAN ST until profile deactivation on 2017-02-23.

Practice Location & Contact Primary Location

Practice Address

104 N Bryan St

Borger, TX 790074010

Telephone 8062473627
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Borger, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.9 Yrs
Regional Practice Density
1 Specialists

Practicing in Borger, TX (11140 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Melanie Black , FNP-C

Nurse Practitioner - Family

NPI 1013558675

Family Nurse Practitioner (Certified)

Chelsea Opdenhoff , APRN, FNP

Nurse Practitioner - Family

NPI 1356887491

Advanced Practice Registered Nurse, Family Nurse Practitioner

Josie Snyder

Nurse Practitioner - Family

NPI 1386312593
Esther Dorman , FNP

Nurse Practitioner - Family

NPI 1588852156

Family Nurse Practitioner

Wendy Kuehler

Nurse Practitioner - Pediatrics

NPI 1699910646
Dr. Dustin Hawley , MD

Family Medicine

NPI 1831416015

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 23, 2017

Record deactivated on February 23, 2017

NPI Profile Active February 06, 2016

NPI status registered as active in NPPES database

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Updated Practice Location February 06, 2016

Registered at 104 N BRYAN ST, BORGER, TX 790074010 (Tel: 8062473627)

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Updated Business Mailing Address February 06, 2016

Registered at 104 N BRYAN ST, BORGER, TX 790074010 (Tel: 8062743627)

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Provider Name / Credentials Updated February 06, 2016

Recorded as BAKE BANNISTER, PA-C

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 06, 2016

Physician Assistant

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Initial NPI Registration & Enumeration October 08, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1972974525
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 08, 2015
Last Update: February 06, 2016
Deactivation Date: February 23, 2017

Mailing Address

104 N Bryan St

Borger, TX 790074010

Phone: 8062743627

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.