Active NPI
Manirul Hoq Khan, MD
- Internal Medicine Physician
- Wichita, KS
National Provider Identifier
1205878188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 04-30171
- Practice address
- 5500 E Kellogg Dr
Wichita, KS 67218-1607 - Phone
- (316) 651-3654
- Fax
- (316) 634-3065
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 04-30171 | KS | Primary |
Addresses
Primary practice location
5500 E Kellogg Dr
Wichita, KS 67218-1607
Mailing address
1348 Country Walk Cir
Wichita, KS 67206-4102
Phone (316) 652-7173
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-30171 | KS | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205878188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1348 COUNTRY WALK CIR",
"city": "WICHITA",
"state": "KS",
"postal_code": "672064102",
"telephone_number": "316-652-7173",
"fax_number": "316-634-3065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 E KELLOGG DR",
"city": "WICHITA",
"state": "KS",
"postal_code": "672181607",
"telephone_number": "316-651-3654",
"fax_number": "316-634-3065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MANIRUL",
"middle_name": "HOQ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KS",
"license": "04-30171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.