NPIMap

Organization Active NPI

Mind MD LLC

  • Child & Adolescent Psychiatry Physician
  • Lafayette, IN
National Provider Identifier
1215334008
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
01061501A Issued in IN
Legal business name
MIND MD LLC
Practice address
833 Park East Blvd
Lafayette, IN 47905-0785
Phone
(765) 743-4400
Fax
(765) 743-4411
NPI assigned
Nov 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Authorized official

Name
Dr. Syed J Khan, M.D.
Title
Owner
Phone
(347) 432-4848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X 01061501A IN Primary

Addresses

Primary practice location

833 Park East Blvd
Lafayette, IN 47905-0785

Mailing address

PO Box 182255
Columbus, OH 43218-2255
Phone (614) 430-5707

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1215334008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182255",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432182255",
            "telephone_number": "614-430-5707",
            "fax_number": "614-430-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 PARK EAST BLVD",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479050785",
            "telephone_number": "765-743-4400",
            "fax_number": "765-743-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-432-4848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01061501A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.