Individual provider Active NPI

Ghazala Parvez Khan, M.D

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1053447219
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME98031 Issued in FL
Practice address
1030 Jefferson Ave
Memphis, TN 38104-2127
Phone
(901) 523-8900
Fax
(901) 522-3431
NPI assigned
Feb 24, 2007
Last updated
Jan 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME98031 FL Primary

Addresses

Primary practice location

1030 Jefferson Ave
Memphis, TN 38104-2127

Mailing address

1030 Jefferson Ave
Memphis, TN 38104-2127
Phone (901) 523-8990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20200707003354 TN Order and Referring Only - Family PracticePractitioner - Family Practice 2860586856

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME98031FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Minor Medical Centers Inc Family Medicine CurrentSince Jan 1, 2006 Accepting new patients
Gainesville Family Physicians P a Family Medicine Past Accepting new patients

Locations

3295 Poplar Ave
Ste 105
Memphis, TN 38111
Phone (901) 327-8188

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1053447219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042127",
            "telephone_number": "901-523-8990",
            "fax_number": "901-522-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042127",
            "telephone_number": "901-523-8900",
            "fax_number": "901-522-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "GHAZALA",
        "middle_name": "PARVEZ",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-24",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME98031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.