Individual provider Active NPI

Fozia Muhstaqe Khan, M.D.

  • Internal Medicine Physician
  • Burlington, NC
National Provider Identifier
1053401430
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9701007 Issued in NC
Practice address
2991 Crouse LN
Burlington, NC 27215-8833
Phone
(336) 586-0994
Fax
(336) 586-9363
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9701007 NC Primary

Addresses

Primary practice location

2991 Crouse LN
Burlington, NC 27215-8833

Mailing address

2991 Crouse Lane
Burlington, NC 27215
Phone (336) 586-0994

Other identifiers 11

IdentifierTypeStateIssuer
263669OtherNCM.D.
5177OtherNCM.D.
37245OtherNCM.D.
0407830OtherNCUHC PROVIDER NUMBER
5955667OtherNCM.D.
83435OtherNCMEDCOST PROVIDER NUMBER
8911599MedicaidNC
11599OtherNCBCBS PROVIDRE NUMBER
27313OtherNCPARTNERS PROVIDER M.D.
62413OtherNCM.D.
20428OtherNCM.D.

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
I20101006001002 NC Practitioner - Internal Medicine 9335331552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nova Medical Associates LLCGroup PAC ID 3375587488, 2 clinicians

Practice addresses (Care Compare)

2991 Crouse LN
Burlington, NC 27215-8833
Phone (336) 586-0994

Hospital & facility affiliations

  • Alamance Regional Medical Center Hospital, Burlington, NC, CCN 340070
  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9701007NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Medical Associates LLC CurrentSince Dec 1, 1998 Accepting new patients

Locations

2991 Crouse Ln
Burlington, NC 27215
Phone (336) 586-0994

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.

Hospital & facility affiliations 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053401430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2991 CROUSE LANE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27215",
            "telephone_number": "336-586-0994",
            "fax_number": "336-586-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2991 CROUSE LN",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158833",
            "telephone_number": "336-586-0994",
            "fax_number": "336-586-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "FOZIA",
        "middle_name": "MUHSTAQE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9701007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D.",
            "identifier": "263669",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D.",
            "identifier": "5177",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D.",
            "identifier": "37245",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PROVIDER NUMBER",
            "identifier": "0407830",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D.",
            "identifier": "5955667",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PROVIDER NUMBER",
            "identifier": "83435",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911599",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDRE NUMBER",
            "identifier": "11599",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PROVIDER  M.D.",
            "identifier": "27313",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D.",
            "identifier": "62413",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D.",
            "identifier": "20428",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

Verify at the official NPI Registry.