Individual provider Active NPI

Anjum Khera, MD

  • Specialist
  • Manchester, CT
National Provider Identifier
1023047784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
033555 Issued in CT
Practice address
935 Main St
Manchester, CT 06040-6059
Phone
(860) 649-6166
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 033555 CT Primary

Addresses

Primary practice location

935 Main St
Manchester, CT 06040-6059

Mailing address

935 Main St
Manchester, CT 06040-6059
Phone (860) 649-6166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
033555CTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Pediatrics LLC CurrentSince Jan 26, 2022 Accepting new patients

Locations

945 Main St
Ste 212
Manchester, CT 06040
Phone (860) 649-6166

Organizations & group practices 1

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023047784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406059",
            "telephone_number": "860-649-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406059",
            "telephone_number": "860-649-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHERA",
        "first_name": "ANJUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "033555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.