W Douglas Back, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

21381 Issued in KY

Practice address

715 Shaker Drive
Suite 120
Lexington, KY 40504-3674

Phone

(859) 278-8443

NPI assigned

Jul 20, 2006

Last updated

May 5, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Wayne Douglas Back Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Bluegrass Eyecare Center, PLLC

  • Ophthalmology Physician
  • Lexington, KY
  • NPI 1063680304
  Authorized official Same address or phone
• Physician's Eye Center, PSC

  • Ophthalmology Physician
  • Lexington, KY
  • NPI 1902076714
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1396765251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SHAKER DRIVE",
            "address_2": "SUITE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043674",
            "telephone_number": "859-278-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 SHAKER DRIVE",
            "address_2": "SUITE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043674",
            "telephone_number": "859-278-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "W DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "21381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WAYNE",
            "last_name": "BACK",
            "middle_name": "DOUGLAS",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Paul Bachner, MD
• Back Talk Chiropractic PSC
• Brittany Bianca Back, DPT
• Lia Back, PA
• Treven Back, APRN, PMHNP-BC
• Carl Lewis Backer, M.D.
• Mircea Backhurst
• James David Bacon, M.D.
• Matthew Keith Bacon, M.D.
• Ioana Patricia Bacus, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.