NPIMap

Individual provider Active NPI

Mishaal Khan, PA-C

  • Physician Assistant
  • Chester, VA
National Provider Identifier
1154188324
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009972 Issued in VA
Practice address
12101 S Chalkley Rd
Chester, VA 23831-3755
Phone
(804) 796-3636
NPI assigned
Mar 4, 2024
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110009972 VA Primary

Addresses

Primary practice location

12101 S Chalkley Rd
Chester, VA 23831-3755

Mailing address

12111 Hogans Aly
Chester, VA 23836-8611
Phone (804) 931-6866

Other practice location 1

12111 Hogans Aly
Chester, VA 23836-8611
Phone (804) 931-6866

Other practice location 2

241 Charles H Dimmock Pkwy Ste 6
Colonial Heights, VA 23834-2915
Phone (804) 765-5320

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522000455 VA Practitioner - Physician Assistant 4587005095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

241 Charles H Dimmock Pkwy
Suite 6
Colonial Heights, VA 23834-2915
Phone (804) 765-5320

40 Medical Park Blvd
Petersburg, VA 23805-9289

511 Belfield Dr
Emporia, VA 23847-1217
Phone (434) 336-1222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince May 4, 2025 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince May 4, 2025 Accepting new patients

Locations

241 Charles H Dimmock Pkwy
Ste 6
Colonial Heights, VA 23834
Phone (804) 526-1111

702 N Main St
Emporia, VA 23847
Phone (434) 634-7723

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5855 Bremo Rd
Ste 601
Richmond, VA 23226
Phone (804) 523-9200

Interoperability endpoints

  • Direct secure messaging: mkhan2813580@direct.bsmhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1154188324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12111 HOGANS ALY",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238368611",
            "telephone_number": "804-931-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 S CHALKLEY RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238313755",
            "telephone_number": "804-796-3636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12111 Hogans Aly",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "VA",
            "postal_code": "238368611",
            "country_code": "US",
            "telephone_number": "804-931-6866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "241 Charles H Dimmock Pkwy Ste 6",
            "address_purpose": "LOCATION",
            "city": "Colonial Heights",
            "state": "VA",
            "postal_code": "238342915",
            "country_code": "US",
            "telephone_number": "804-765-5320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MISHAAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "12101 S Chalkley Rd",
            "city": "Chester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "238313755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

Verify at the official NPI Registry.