Active NPI
Iman Lynn Khan, M.S.
- Professional Counselor
- Franklin, WI
National Provider Identifier
1083973861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4771-125
- Practice address
- 8800 S 102ND St
103
Franklin, WI 53132-7712 - Phone
- (414) 858-1014
- Fax
- (414) 858-1017
- NPI assigned
- May 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4771-125 | WI | Primary |
Addresses
Primary practice location
8800 S 102ND St
103
Franklin, WI 53132-7712
Mailing address
1253 30TH CT
Unit F
Kenosha, WI 53144
Phone (414) 745-4722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4771-125 | WI | MD | Professional Counselor |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336953600000",
"number": "1083973861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1253 30TH CT",
"address_2": "UNIT F",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53144",
"telephone_number": "414-745-4722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8800 S 102ND ST",
"address_2": "103",
"city": "FRANKLIN",
"state": "WI",
"postal_code": "531327712",
"telephone_number": "414-858-1014",
"fax_number": "414-858-1017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "IMAN",
"middle_name": "LYNN",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-14",
"last_updated": "2012-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "4771-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Franklin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.