Individual provider Active NPI

Sher Ali Khan, M.D

  • Addiction Medicine (Preventive Medicine) Physician
  • Gallup, NM
National Provider Identifier
1104372200
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
MD2022-1359 Issued in NM
Practice address
1900 Red Rock Dr
Gallup, NM 87301-5682
Phone
(505) 863-1820
NPI assigned
Aug 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.067977 IL
Student in an Organized Health Care Education/Training Program 390200000X RS2020-0468 NM
Addiction Medicine (Preventive Medicine) Physician 2083A0300X MD2022-1359 NM Primary

Addresses

Primary practice location

1900 Red Rock Dr
Gallup, NM 87301-5682

Mailing address

1900 Red Rock Dr
Gallup, NM 87301-5682
Phone (505) 863-1820

Other practice location 1

1901 Red Rock Dr
Gallup, NM 87301-5683
Phone (505) 863-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231110001478 NM Practitioner - Internal Medicine 9638467616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1900 Red Rock Dr
Gallup, NM 87301-5682
Phone (505) 863-1820

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Oct 27, 2023 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Family Medicine CurrentSince Oct 27, 2023 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients

Locations

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

2111 College Dr
Gallup, NM 87301
Phone (505) 397-5172

1900 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-1820

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1104372200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 RED ROCK DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015682",
            "telephone_number": "505-863-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RED ROCK DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015682",
            "telephone_number": "505-863-1820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Red Rock Dr",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873015683",
            "country_code": "US",
            "telephone_number": "505-863-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHER ALI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-29",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.067977",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2020-0468",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "NM",
            "license": "MD2022-1359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.