Active NPI
Ghazala Y Khan, MD
- Pediatrics Physician
- Virginia Beach, VA
National Provider Identifier
1154382018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101042942
- Practice address
- 4221 Pleasant Valley Rd
Suite 114
Virginia Beach, VA 23464-8519 - Phone
- (757) 495-7420
- Fax
- (757) 495-3917
- NPI assigned
- Mar 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101042942 | VA | Primary |
Addresses
Primary practice location
4221 Pleasant Valley Rd
Suite 114
Virginia Beach, VA 23464-8519
Mailing address
4221 Pleasant Valley Rd
Suite 114
Virginia Beach, VA 23464-8519
Phone (757) 495-7420
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33003 | Other | VA | OPTIMA HEALTH PLAN |
| 330829 | Other | VA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101042942 | VA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pleasant Valley Medical Center, Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Virginia Beach, VA
- NPI 1295826071
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202860800000",
"number": "1154382018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4221 PLEASANT VALLEY RD",
"address_2": "SUITE 114",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234648519",
"telephone_number": "757-495-7420",
"fax_number": "757-495-3917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4221 PLEASANT VALLEY RD",
"address_2": "SUITE 114",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234648519",
"telephone_number": "757-495-7420",
"fax_number": "757-495-3917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "GHAZALA",
"middle_name": "Y",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-30",
"last_updated": "2008-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101042942",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA HEALTH PLAN",
"identifier": "33003",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "330829",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.