Himabindu Bandaru, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

9065324-1205 Issued in UT

Practice address

1200 E 3900 S
Suite 4B
Salt Lake City, UT 84124-1300

Phone

(866) 500-7071

Fax

(866) 500-7081

NPI assigned

Jun 3, 2007

Last updated

Jul 7, 2014By 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 5

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Wellmont Physician Services Inc

  • Internal Medicine Physician
  • Big Stone Gap, VA
  • NPI 1619095403
  NPD (past)

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1750583746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 S 2940 E",
            "address_2": "PO BOX 9677",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841093159",
            "telephone_number": "866-500-7071",
            "fax_number": "866-500-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E 3900 S",
            "address_2": "SUITE 4B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241300",
            "telephone_number": "866-500-7071",
            "fax_number": "866-500-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDARU",
        "first_name": "HIMABINDU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-03",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301086019",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101243676",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N8272",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101243676",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "9065324-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750583746",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100049880",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP PIN",
            "identifier": "0G56008",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "1107510812",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kami Balmforth, LCSW
• Sara Anne Balte
• Marie Dufresne Bambo, PT
• Andrew Bambrough
• Michele Bamgartner, MD
• David Bandbaz
• Trisha Lynn Bandeka-Bennett, RN
• Daniel Edmund Banellis
• Taryn Banfield, DPT
• Madison Bangert, M.D

• Hospitalist Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Hospitalist Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.