Organization Active NPI

Riad G Khoury PC

  • Pain Medicine (Anesthesiology) Physician
  • Farmington Hills, MI
National Provider Identifier
1114050499
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
4301038502 Issued in MI
Legal business name
RIAD G KHOURY PC
Practice address
28521 Orchard Lake Rd Ste C
Farmington Hills, MI 48334-2934
Phone
(248) 987-6190
Fax
(248) 987-6193
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Riad G Khoury, MD
Title
Owner
Phone
(248) 987-6190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 4301038502 MI Primary

Addresses

Primary practice location

28521 Orchard Lake Rd Ste C
Farmington Hills, MI 48334-2934

Mailing address

28521 Orchard Lake Rd
Suite C
Farmington Hills, MI 48334-2934
Phone (248) 987-6190

Other identifiers 4

IdentifierTypeStateIssuer
050F353180OtherMIBCN GRP
6805110001OtherMIDME PTAN
050F353180OtherMIBCBS GRP
1114050499MedicaidMI

National Provider Directory

National Provider Directory

Locations

1458 Momentum Pl
Chicago, IL 60689

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1114050499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28521 ORCHARD LAKE RD",
            "address_2": "SUITE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342934",
            "telephone_number": "248-987-6190",
            "fax_number": "248-987-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28521 ORCHARD LAKE RD STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342934",
            "telephone_number": "248-987-6190",
            "fax_number": "248-987-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIAD G KHOURY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "KHOURY",
        "authorized_official_first_name": "RIAD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-987-6190",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301038502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GRP",
            "identifier": "050F353180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN",
            "identifier": "6805110001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP",
            "identifier": "050F353180",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114050499",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.