Dr Wachovia Chanta' Banks, DO is a medicare enrolled "Family Medicine" physician in Blythewood, South Carolina. Her current practice location is
1175 Grey Pine Dr, Blythewood, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 995-5599.
Dr Wachovia Chanta' Banks is licensed to practice in Louisiana (license number COVID19-TMP-211) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1487880126.
Physician's Profile
| Full Name | Dr Wachovia Chanta' Banks |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 1175 Grey Pine Dr, Blythewood, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1487880126
- Provider Enumeration Date: 06/09/2009
- Last Update Date: 01/06/2022
Medicare PECOS Information:
- PECOS PAC ID: 4880957505
- Enrollment ID: I20180411001541
Medical Identifiers
Medical identifiers for Dr Wachovia Chanta' Banks such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1487880126 | NPI | - | NPPES |
| 518700 | Medicaid | SC | |
| 2570986 | Medicaid | LA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | OT013286 (Pennsylvania) | Secondary |
| 207Q00000X | Family Medicine | 51870 (South Carolina) | Secondary |
| 208D00000X | General Practice | OT013286 (Pennsylvania) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | COVID19-TMP-211 (Louisiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Wachovia Chanta' Banks allows following entities to bill medicare on her behalf.
| Entity Name | Signify Health Medical Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20191209002986 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Wachovia Chanta' Banks is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Wachovia Chanta' Banks, DO
5800 Brunswick Ct,
New Orleans, LA 70131-5425
Ph: (717) 880-3740 | Dr Wachovia Chanta' Banks, DO
1175 Grey Pine Dr,
Blythewood, SC 29016-7320
Ph: (803) 995-5599 |
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