Individual provider Active NPI

Shaheen Khan, M.D.

  • Internal Medicine Physician
  • Morganton, NC
National Provider Identifier
1013939446
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200100719 Issued in NC
Practice address
2201 S Sterling St
Morganton, NC 28655-4044
Phone
(828) 580-6753
Fax
(828) 580-6759
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 200100719 NC
Internal Medicine Physician 207R00000X 200100719 NC Primary

Addresses

Primary practice location

2201 S Sterling St
Morganton, NC 28655-4044

Mailing address

4158 2ND St NW
Hickory, NC 28601-8091
Phone (828) 391-7641

Other identifiers 1

IdentifierTypeStateIssuer
1013939446MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20051031000820 NC Practitioner - Internal Medicine 1153348909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians
Optimed HospitalistsGroup PAC ID 8022204171, 47 clinicians

Practice addresses (Care Compare)

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

557 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 873-5661

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

  • Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200100719NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince May 1, 2014 Accepting new patients
Optimed Hospitalists Internal Medicine CurrentSince Dec 1, 2016 Accepting new patients
Optimed Hospitalists Hospitalist CurrentSince Dec 1, 2016 Accepting new patients
Catawba Valley Medical Center Current Accepting new patients
Caromont Medical Group Inc Family Medicine CurrentSince May 1, 2014 Accepting new patients
Caromont Medical Group Inc Family Medicine Current Accepting new patients
Carolina Inpatient Medical Specialists, PLLC Hospitalist Past Accepting new patients
Wakemed Faculty Practice Plan Hospitalist Past Accepting new patients
Fryecare Physicians , LLC Past Accepting new patients
Wakemed Faculty Practice Plan Family Medicine Past Accepting new patients

Locations

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1013939446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4158 2ND ST NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286018091",
            "telephone_number": "828-391-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S STERLING ST",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554044",
            "telephone_number": "828-580-6753",
            "fax_number": "828-580-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAHEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "200100719",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200100719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013939446",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganton, NC

Sources for this page

Verify at the official NPI Registry.