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DR. KELLY NICOLE BANNEYER PHD
NPI 1104314533
Psychologist - Clinical Child & Adolescent in Houston, TX

Active since May 01, 2018PECOS Enrolled
6701 FANNIN ST STE 1630, HOUSTON, TX 77030(832) 822-3700(832) 825-4164 Get Directions Write a Review

NPPES record last updated: May 1, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Kelly Nicole Banneyer Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY NICOLE BANNEYER PHD (NPI 1104314533) is an individual clinical child & adolescent provider in Houston, Texas, licensed in Texas (37690) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104314533
Entity TypeIndividualFemale
Primary Taxonomy103TC2200X
Provider Legal NameDR. KELLY NICOLE BANNEYERCredential: PHD
Location Address6701 FANNIN ST STE 1630Houston, TX 77030-2615
Mailing Address6701 Fannin St Ste 1630Houston, TX 77030-2615 · (832) 822-3700 · Fax (832) 825-4164
Phone(832) 822-3700
Fax(832) 825-4164
Sole ProprietorNo
Enumeration DateMay 1, 2018
✔ NPI 1104314533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers
Taxonomy Code103TC2200X
License✔ Licensed in TX · 37690
Definition
A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.
6701 FANNIN ST STE 1630, Houston, TX 77030
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly Nicole Banneyer Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Banneyer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Texas Children's Physician Group
0.1 mi
Pediatrics
6621 FANNIN ST
Houston, TX 77030
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Texas Childrens Physician Group
  • 2,498 clinicians in this Medicare group
NPI 1861675506 (832) 824-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTIAN OLIVIA LEDET PHD
Psychologist (Clinical)
6701 FANNIN ST STE 1630
HOUSTON, TX 77030
Harris County (832) 822-3700
JENNIFER AGNES REECE BCBA
Behavior Analyst
6701 FANNIN ST STE 1630
HOUSTON, TX 77030
Harris County (832) 822-3700
DR. KATHERINE ANNE GALLAGHER PH.D.
Psychologist (Clinical)
6701 FANNIN ST STE 1630
HOUSTON, TX 77030
Harris County (832) 822-3700
CASEY ELIZABETH SWICK PHD
Psychologist (Clinical)
6701 FANNIN ST STE 1630
HOUSTON, TX 77030
Harris County (832) 822-3700
DR. SAMANTHA AMBER DENEE CARREON PHD
Psychologist
6701 FANNIN ST STE 1630
HOUSTON, TX 77030
Harris County (832) 822-3700
MRS. MARISA BROOKE NOWITZ LCSW
Social Worker (Clinical)
6701 FANNIN ST STE 1630
HOUSTON, TX 77030
Harris County (832) 692-1570
RACHEL KENTOR PHD
Psychologist
6701 FANNIN ST STE 1630
HOUSTON, TX 77030
Harris County (832) 822-3878
JULIA D KOVALENKO PHD
Psychologist (Clinical)
6701 FANNIN ST STE 1630
HOUSTON, TX 77030
Harris County (832) 822-1888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Banneyer's NPI number?

The NPI number for Kelly Banneyer is 1104314533. It was assigned to this individual provider in the NPPES registry on May 1, 2018.

Where is Kelly Banneyer located?

Kelly Banneyer practices at 6701 Fannin St Ste 1630, Houston, TX 77030. The listed phone number is (832) 822-3700.

What is Kelly Banneyer's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Kelly Banneyer enrolled in Medicare?

Yes. Kelly Banneyer is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Banneyer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Banneyer reassigns Medicare benefits to Texas Children's Physician Group (Houston, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Banneyer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Banneyer accept?

Health plans from Cigna Healthcare and Moda Health Plan, Inc. list Kelly Banneyer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Banneyer was last updated on May 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.