Fahim Uzzaman Khan, CPO

Primary specialty

OrthotistTaxonomy code 222Z00000X

License

CPO02454 Issued in MD

Practice address

1900 South Ave
La Crosse, WI 54601-5467

Phone

(608) 775-4010

Fax

(608) 775-6723

NPI assigned

Mar 8, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1235679366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 MILLER ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018505",
            "telephone_number": "608-775-4010",
            "fax_number": "608-775-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015467",
            "telephone_number": "608-775-4010",
            "fax_number": "608-775-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "FAHIM",
        "middle_name": "UZZAMAN",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "MD",
            "license": "CPO02454",
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "MD",
            "license": "CPO02454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya L Kessen, LPC
• Staci M Kestner, CSW
• Maude Kettenmann, M.D.
• Kevin B. Cook, D.D.S., S.C.
• Sarah S Keyeski, MA
• Hina Rmsha Alfia Khan, M.B.B.S
• Muhammad Shoaib Khan
• Kidspace LLC
• Gina Kiefer, RN
• Kaitlyn Kiel, NP

• All providers in La Crosse, WI
• Orthotist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.