NPIMap

Organization Active NPI

Neuro Care of Virginia PC

  • Neurology Physician
  • Prince George, VA
National Provider Identifier
1124087812
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEURO CARE OF VIRGINIA PC
Practice address
4720 Puddledock Rd
Suite 100
Prince George, VA 23875-1237
Phone
(804) 452-4546
Fax
(804) 452-4549
NPI assigned
Mar 21, 2006
Last updated
Aug 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Authorized official

Name
Mubashir A Khan, MDNPI 1023087368
Title
President
Phone
(804) 452-4546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

4720 Puddledock Rd
Suite 100
Prince George, VA 23875-1237

Mailing address

4720 Puddledock Rd
Suite 100
Prince George, VA 23875-1237
Phone (804) 452-4546

Other identifiers 3

IdentifierTypeStateIssuer
1710154786OtherVADR. BU NPI
1023087368OtherVADR. KHAN NPI
C08332OtherMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070508000622 VA Part B Supplier - Clinic/Group Practice 5991801987 Receives reassigned benefits from 5 practitioners
Practice locations: Hopewell, VA; Midlothian, VA; Prince George, VA

National Provider Directory

National Provider Directory

Locations

4720 Puddledock Rd
#100
Prince George, VA 23875
Phone (804) 452-4546

4720 Puddledock Rd
Ste 100
Prince George, VA 23875
Phone (804) 452-4546

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4844/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1124087812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 PUDDLEDOCK RD",
            "address_2": "SUITE 100",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238751237",
            "telephone_number": "804-452-4546",
            "fax_number": "804-452-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 PUDDLEDOCK RD",
            "address_2": "SUITE 100",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238751237",
            "telephone_number": "804-452-4546",
            "fax_number": "804-452-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO CARE OF VIRGINIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MUBASHIR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-452-4546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BU NPI",
            "identifier": "1710154786",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. KHAN NPI",
            "identifier": "1023087368",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C08332",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince George, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.