SARAH BANNON (ARNP) – Family Nurse Practitioner, NPI 1174360762

SARAH BANNON (ARNP) is a healthcare provider. based in Othello, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. RN61575707 (WA). The NPI Number for SARAH BANNON (ARNP) is 1174360762

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SARAH BANNON (ARNP)
NPI
1174360762
Phone
(509) 488-5256
Address
1515 E COLUMBIA ST
Enumeration Date
10 July 2024
Last Update Date
14 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
50948852568512
Graduation Year
2024 (2 years ago)
PAC ID
7517492077
Group Practice PAC ID
4486564309
Professional Enrollment ID
I20241121001467
Address ID
WA993441846OT1515XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:1State licenses:2Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for SARAH BANNON (ARNP)

  • 1515 E COLUMBIA ST

    OTHELLO, WA 993441846

    Phone: (509) 488-5256

    Fax: (509) 488-9939

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241121001467INurse PractitionerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99344)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486564309View full group profile
NameSpecialtyState
Physician AssistantWA
-WA
Undefined Non Physician Type (Specify), Mental Health CounselorWA
Nurse PractitionerWA
Nurse PractitionerWA
Family PracticeWA
Physician AssistantWA
Physician AssistantWA
Physician AssistantWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

What is SARAH BANNON (ARNP)'s NPI number?
SARAH BANNON (ARNP)'s NPI is 1174360762 — the number used across U.S. healthcare to identify this provider.
Would SARAH BANNON (ARNP) appear as active to a payer?
You can treat SARAH BANNON (ARNP) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with SARAH BANNON (ARNP)?
SARAH BANNON (ARNP)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is SARAH BANNON (ARNP) located near Othello?
SARAH BANNON (ARNP) currently maps to Othello, Washington in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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