Bandana Waikhom, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

48047 Issued in KY

Practice address

7370 Turfway Rd
Suite 300
Florence, KY 41042-4895

Phone

(859) 746-1990

Fax

(859) 746-3149

NPI assigned

Jul 28, 2008

Last updated

Apr 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Medical Group, Inc

  dba St. Elizabeth Physicians

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216

  Ophthalmology

  Medicare reassignment NPD
• Summit Medical Group, Inc.

  dba St. Elizabeth Physicians

  • Foot & Ankle Surgery Podiatrist
  • Crestview Hills, KY
  • NPI 1043188378
  NPD
• University Eye Physicians, Inc

  • Ophthalmology Physician
  • Cincinnati, OH
  • NPI 1992759203
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1053576140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CHAMBER CENTER DR",
            "city": "LAKESIDE PARK",
            "state": "KY",
            "postal_code": "410171686",
            "telephone_number": "859-746-1990",
            "fax_number": "859-746-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 TURFWAY RD",
            "address_2": "SUITE 300",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424895",
            "telephone_number": "859-746-1990",
            "fax_number": "859-746-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIKHOM",
        "first_name": "BANDANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35.084676",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "TP202",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "48047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2925937",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100136710",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vpa PC (VPA Diagnostics)
• Kimberly Wachter
• Melissa Kaye Wafford, APRN
• Amanda Wagers
• Brad Wagner
• Michael Lee Wainscott, APRN
• Kimberly Lynne Waits, BS
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1510)
• Wal-Mart Stores East, LP (Vision Center 30-1510)
• Jason Eric Walden, DMD,MS

• Ophthalmology Physician in Florence, KY
• Providers in Florence, KY by specialty
• Ophthalmology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.