Khadijah Hafsa Bah, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1060344 Issued in TX

Practice address

6107 Gritten Dr
Forney, TX 75126-4169

Phone

(301) 281-7052

NPI assigned

Dec 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Holy Cross OBGYN

  • Obstetrics & Gynecology Physician
  • Mesquite, TX
  • NPI 1720581432
  Medicare reassignment NPD

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1063170066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 GRITTEN DR",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751264169",
            "telephone_number": "301-281-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6107 GRITTEN DR",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751264169",
            "telephone_number": "301-281-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAH",
        "first_name": "KHADIJAH",
        "middle_name": "HAFSA",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "TX",
            "license": "1060344",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TX",
            "license": "1060344",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "1060344",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "1060344",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1060344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "FORNEY",
            "affiliation": "N",
            "address_1": "6107 Gritten Dr",
            "city": "Forney",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751264169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "FORNEY",
            "affiliation": "N",
            "address_1": "6107 GRITTEN DRIVE",
            "city": "FORNEY",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pakiza Aslam
• Carol N Atuma
• Jaquelin Ayala de Leon
• Azure Kids LLC
• Bachimd, P.a.
• Paige Elizabeth Baker, CPNP
• Chidera Eunice Balogun, PMHNP
• Ryan Danielle Balsley, PA-C
• Casey Lea Banks
• Banolt Global Resources LLC

• Family Nurse Practitioner in Forney, TX
• Providers in Forney, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.