Khetlhamany Erika Bannavong, MA, CCC-SLP is a medicare enrolled "Speech-language Pathologist" provider in West Liberty, Iowa. Her current practice location is
1253 Elder Ridge Rd, West Liberty, Iowa. You can reach out to her office (for appointments etc.) via phone at
(195) 417-7853.
Khetlhamany Erika Bannavong is licensed to practice in Pennsylvania (license number SL018239) 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 1245945567.
Healthcare Provider's Profile
| Full Name | Khetlhamany Erika Bannavong |
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| Gender | Female |
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| Speciality | Speech-language Pathologist |
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| Location | 1253 Elder Ridge Rd, West Liberty, Iowa |
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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: 1245945567
- Provider Enumeration Date: 01/20/2023
- Last Update Date: 02/17/2025
Medicare PECOS Information:
- PECOS PAC ID: 6709222482
- Enrollment ID: I20240316000499
Medical Identifiers
Medical identifiers for Khetlhamany Erika Bannavong such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1245945567 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | 114797 (Iowa) | Secondary |
| 235Z00000X | Speech-language Pathologist | SL018239 (Pennsylvania) | 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. Khetlhamany Erika Bannavong allows following entities to bill medicare on her behalf.
| Provider Name | Onr National Speech Pathology Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1972965952
PECOS PAC ID: 2668463522
Enrollment ID: O20190125002828 |
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| Provider Name | Empowerme Asl Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1376138305
PECOS PAC ID: 3476969387
Enrollment ID: O20210310003144 |
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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. Khetlhamany Erika Bannavong 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 |
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Khetlhamany Erika Bannavong, MA, CCC-SLP
1253 Elder Ridge Rd,
West Liberty, IA 52776-9161
Ph: (319) 541-7785 | Khetlhamany Erika Bannavong, MA, CCC-SLP
1253 Elder Ridge Rd,
West Liberty, IA 52776-9161
Ph: (195) 417-7853 |
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