Individual provider Active NPI

Rizwan N Khan, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Louisville, KY
National Provider Identifier
1003981929
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
30278 Issued in KY
Practice address
2137 Dixie Hwy
Louisville, KY 40210-2242
Phone
(502) 712-1292
Fax
(502) 901-9955
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 30278 KY Primary

Addresses

Primary practice location

2137 Dixie Hwy
Louisville, KY 40210-2242

Mailing address

5353 N Federal Hwy Ste 101
Fort Lauderdale, FL 33308-3236
Phone (954) 990-8134

Other identifiers 1

IdentifierTypeStateIssuer
200210020MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20240819000376 KY Practitioner - Physical Medicine and Rehabilitation 4284664921 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Bone & Joint PLLC CurrentSince Apr 25, 2024 Accepting new patients
Critical Access Health Services Corp. Past Accepting new patients
Scott Memorial Hospital Past Accepting new patients
Scott Physician Group LLC Past Accepting new patients

Locations

5353 N Federal Hwy
Ste 101
Ft Lauderdale, FL 33308

2137 Dixie Hwy
Louisville, KY 40210
Phone (502) 712-1292

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1003981929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 N FEDERAL HWY STE 101",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083236",
            "telephone_number": "954-990-8134",
            "fax_number": "954-990-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402102242",
            "telephone_number": "502-712-1292",
            "fax_number": "502-901-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RIZWAN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "KY",
            "license": "30278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200210020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.