NPIMap

Organization Active NPI

Ayesha Khan DO, LLC

  • Psychiatry Physician
  • Laurel, MD
National Provider Identifier
1174153522
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
AYESHA KHAN DO, LLC
Practice address
14201 Laurel Park Dr Ste 215
Laurel, MD 20707-5260
Phone
(240) 690-2828
NPI assigned
Jan 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Authorized official

Name
Ayesha KhanNPI 1093155475
Title
Owner
Phone
(240) 271-0746

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

14201 Laurel Park Dr Ste 215
Laurel, MD 20707-5260

Mailing address

19328 Erin Tree CT
Gaithersburg, MD 20879-4973

National Provider Directory

National Provider Directory

Locations

14201 Laurel Park Dr
Ste 215
Laurel, MD 20707
Phone (240) 690-2828

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1174153522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19328 ERIN TREE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208794973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 LAUREL PARK DR STE 215",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075260",
            "telephone_number": "240-690-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AYESHA KHAN DO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AYESHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-271-0746"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.