Edina Janice Khan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110004926 Issued in VA

Practice address

25 Northridge LN
Lexington, VA 24450

Phone

(540) 464-8700

Fax

(540) 464-1323

NPI assigned

May 19, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Health Center of Southeast Texas

  • Federally Qualified Health Center (FQHC)
  • Cleveland, TX
  • NPI 1265197867
  NPD (past)

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1093034704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 SPRINGHILL RD",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244010000",
            "telephone_number": "609-231-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NORTHRIDGE LN",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "24450",
            "telephone_number": "540-464-8700",
            "fax_number": "540-464-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "EDINA",
        "middle_name": "JANICE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Joseph Kelland, PSY.D., M.A.
• Ayesha Jone' Kelly, MD
• James M. Kennedy Jr., MD
• Tracy Kennedy, CRNP
• Walter Charles Kerschl, MD
• Lance J Kimble, PT, DPT
• Sierra Morgan Knick-Bradberry, RBT
• Tammy Knick, FNP-C
• Judy Ko, MD
• Laura P Kornegay, MD

• Physician Assistant in Lexington, VA
• Providers in Lexington, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.