Shraddha Jai Khokhal

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5019413 Issued in NC

Practice address

3402 Battleground Ave
Greensboro, NC 27410-2578

Phone

(336) 883-0029

Fax

(336) 883-0867

NPI assigned

Jan 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethany Medical CenterGroup PAC ID 4486614575, 71 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shraddhakhokhal@bethanymed.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bethany Medical Center

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1952404188

  Pain Medicine

  Medicare reassignment Care Compare group NPD
• Bethany Medical Center

  • Internal Medicine Physician
  • Kernersville, NC
  • NPI 1861049231
  NPD
• Bethany Medical Center, PA

  • Family Medicine Physician
  • High Point, NC
  • NPI 1508459306
  NPD
• Bethany Medical Center

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1316303076

  Nurse Practitioner

  NPD (past)
• Bethany Medical Center

  • Anatomic Pathology & Clinical Pathology Physician
  • Kernersville, NC
  • NPI 1619398997
  NPD (past)
• Bethany Medical Center PA

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1740381581
  NPD (past)
• Bethany Medical Center, PA

  • Cardiovascular Disease Physician
  • High Point, NC
  • NPI 1174722391
  NPD (past)

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

{
    "created_epoch": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1215707096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N MAIN ST",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605017",
            "telephone_number": "336-883-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 BATTLEGROUND AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102578",
            "telephone_number": "336-883-0029",
            "fax_number": "336-883-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOKHAL",
        "first_name": "SHRADDHA",
        "middle_name": "JAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "5019413",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019413",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ghalib Khan, MD
• Haakib Khan, PHARMD
• Ridwana Khan
• Salaar Rehman Khan, DDS
• Hina Khatri, PA-C
• KHS LLC
• Suzanna Kidd, LCSW
• William Bryan Kidd, MPT
• Kidneycare-NC
• Mandi Kido

• Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.