Individual provider Active NPI

Mitchell Kahn, M.D.

  • Internal Medicine Physician
  • Bellingham, WA
National Provider Identifier
1174564751
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0004637 Issued in WA
Practice address
113 Sea Pines LN
Bellingham, WA 98229-9363
Phone
(360) 797-5187
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 131709 NY
Internal Medicine Physician 207R00000X MD0004637 WA Primary

Addresses

Primary practice location

113 Sea Pines LN
Bellingham, WA 98229-9363

Mailing address

113 Sea Pines LN
Bellingham, WA 98229-9363
Phone (360) 797-5187

Other identifiers 1

IdentifierTypeStateIssuer
8465494MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
131709NYMDInternal Medicine Physician
MD0004637WAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1174564751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 SEA PINES LN",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982299363",
            "telephone_number": "360-797-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 SEA PINES LN",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982299363",
            "telephone_number": "360-797-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-01-02",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "131709",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD0004637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8465494",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.