NPIMap

Organization Active NPI

Horizon Medical Care. LLC

  • Internal Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1063698652
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200200823 Issued in MO
Legal business name
HORIZON MEDICAL CARE. LLC
Practice address
930 Kingscove CT
Chesterfield, MO 63017-8350
Phone
(314) 289-6636
Fax
(636) 778-9068
NPI assigned
Jan 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Authorized official

Name
Dr. Fedwa S Khalifa, M.D.
Title
Owner
Phone
(314) 837-3720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 200200823 MO Primary

Addresses

Primary practice location

930 Kingscove CT
Chesterfield, MO 63017-8350

Mailing address

PO Box 6524
Chesterfield, MO 63006-6524
Phone (314) 432-2580

National Provider Directory

National Provider Directory

Locations

15826 Clayton Rd
Ellisville, MO 63011
Phone (314) 737-4629

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1063698652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6524",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630066524",
            "telephone_number": "314-432-2580",
            "fax_number": "314-432-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 KINGSCOVE CT",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178350",
            "telephone_number": "314-289-6636",
            "fax_number": "636-778-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORIZON MEDICAL CARE. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "KHALIFA",
        "authorized_official_first_name": "FEDWA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-837-3720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "200200823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.