Organization Active NPI

Huma Khusro MD PC

  • Adult Mental Health Clinic/Center
  • Gadsden, AL
National Provider Identifier
1083819924
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
19471 Issued in AL
Legal business name
HUMA KHUSRO MD PC
Practice address
106 Bay St
Gadsden, AL 35901-5229
Phone
(256) 547-7778
Fax
(256) 547-7709
NPI assigned
Jun 20, 2007
Last updated
Dec 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Authorized official

Name
Dr. Huma Khusro, M.D.NPI 1104929587
Title
President
Phone
(256) 547-7778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 19471 AL Primary

Addresses

Primary practice location

106 Bay St
Gadsden, AL 35901-5229

Mailing address

106 Bay St
Gadsden, AL 35901-5229
Phone (256) 547-7778

Other identifiers 1

IdentifierTypeStateIssuer
529909210MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070822000286 AL Part B Supplier - Clinic/Group Practice 3971695008 Receives reassigned benefits from 1 practitioner
Practice locations: Gadsden, AL

National Provider Directory

National Provider Directory

Locations

600 S 3rd St
Ste 735
Gadsden, AL 35901
Phone (256) 441-0966

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1083819924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BAY ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015229",
            "telephone_number": "256-547-7778",
            "fax_number": "256-547-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BAY ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015229",
            "telephone_number": "256-547-7778",
            "fax_number": "256-547-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMA KHUSRO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "KHUSRO",
        "authorized_official_first_name": "HUMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-547-7778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AL",
            "license": "19471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529909210",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.