Bhavna Vaidya-Tank, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2004-00430 Issued in NC

Practice address

2076 NC Highway 42 W
Ste. 230
Clayton, NC 27520-5302

Phone

(919) 553-5711

Fax

(919) 553-5712

NPI assigned

May 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bvaidya34593@fastmed.direct-ci.com

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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  Medicare reassignment Care Compare group NPD
• Family Wellness Clinic

  • Clinical Medical Laboratory
  • Clayton, NC
  • NPI 1801294665
  Authorized official Same address or phone
• Crossroads Family Chiropractic

  • Chiropractor
  • Benson, NC
  • NPI 1326155078
  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1316992639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 WADE PARK BLVD",
            "address_2": "STE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276074188",
            "telephone_number": "919-851-2174",
            "fax_number": "919-854-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2076 NC HIGHWAY 42 W",
            "address_2": "STE. 230",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205302",
            "telephone_number": "919-553-5711",
            "fax_number": "919-553-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYA-TANK",
        "first_name": "BHAVNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2004-00430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891372V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "138WA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Unity Residential Service Inc.
• Nicole Upah, PA-C
• Megan Upchurch
• Urgent Cares of America North Carolina Inc (Fastmed Urgent Care of Clayton)
• Sarah Jonell Utley, LCSWA
• Claire Vallery, CO
• Erin Grace Van Vactor, NCC, LCMHC, M.S.
• Kelly Jo Vancelette, L.C.S.W.
• Laura M Varela
• Rachael Purvis Veazey, DDS

• Family Medicine Physician in Clayton, NC
• Providers in Clayton, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.