Khan Matin, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

22483 Issued in KY

Practice address

3701 Lansdowne Dr
Ashland, KY 41101

Phone

(606) 324-3005

Fax

(606) 329-1530

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Mushtaque Ahmed MD PSC

  • Internal Medicine Physician
  • Ashland, KY
  • NPI 1346209996
  NPD (past)
• Paul E. Arnold, DMD., PSC.

  • Durable Medical Equipment & Medical Supplies
  • Russell, KY
  • NPI 1619475456
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1124033931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411050790",
            "telephone_number": "606-329-8588",
            "fax_number": "606-329-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 LANSDOWNE DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "41101",
            "telephone_number": "606-324-3005",
            "fax_number": "606-329-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIN",
        "first_name": "KHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "22483",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "35050198",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64224835",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0806677",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11101867",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHLAND HOSPITAL CORP (KDMC) MEDICARE PTAN",
            "identifier": "3402033",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114374000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE PTAN",
            "identifier": "1669101",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PATHWAYS GROUP NPI #",
            "identifier": "1982615043",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GPA RR MEDICARE",
            "identifier": "260031769",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30610026",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN # - PATHWAYS, INC.",
            "identifier": "0519303",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005355002",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Reams MD
• Melba Mechelle Massie, PA
• Sonya Renee Massie, APRN
• Paul S. Matharoo, MD
• Mathew.P.Samuel,MD PSC
• Matthew J Pierzala DO PSC
• Maurice J. Oakley,M.D.,P.S.C.
• Melissa Jo Mavis, ARNP
• Amanda Rose Maxim, M.S., CCC-SLP
• Crystal Mayes

• All providers in Ashland, KY
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.