Individual provider Active NPI

Anquenetta Michelle Pendleton Khan

  • Primary Care Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1174464499
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1-118517 Issued in AL
Practice address
7278 Cahaba Valley Rd Apt 914B
Birmingham, AL 35242-8410
Phone
(205) 903-0041
NPI assigned
Apr 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1-118517 AL Primary
Gerontology Nurse Practitioner 363LG0600X 1-118517 AL

Addresses

Primary practice location

7278 Cahaba Valley Rd Apt 914B
Birmingham, AL 35242-8410

Mailing address

7278 Cahaba Valley Rd Apt 914B
Birmingham, AL 35242-8410
Phone (205) 903-0041

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

State licenses

LicenseStateTypeSpecialty
1-118517ALMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1174464499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7278 CAHABA VALLEY RD APT 914B",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352428410",
            "telephone_number": "205-903-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7278 CAHABA VALLEY RD APT 914B",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352428410",
            "telephone_number": "205-903-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON KHAN",
        "first_name": "ANQUENETTA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AL",
            "license": "1-118517",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-118517",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; 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.