Individual provider Active NPI

Sairah Khadija, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Gastonia, NC
National Provider Identifier
1255828752
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2023-02827 Issued in NC
Practice address
2544 Court Dr Ste a
Gastonia, NC 28054-3450
Phone
(704) 671-6400
Fax
(704) 671-6449
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2023-02827 NC Primary

Addresses

Primary practice location

2544 Court Dr Ste a
Gastonia, NC 28054-3450

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240214000893 NC Practitioner - Internal Medicine 2466797543 Reassigns benefits to 1 organization
I20240403003782 SC Practitioner - Internal Medicine 2466797543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, shared by 2 NPIs, 425 clinicians

Practice addresses (Care Compare)

1200 Village Harbor Dr
Suite C
Lake Wylie, SC 29710-9092
Phone (704) 834-3278

2544 Court Dr
Suite a
Gastonia, NC 28054-3450
Phone (704) 671-6400

Hospital & facility affiliations

  • Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2023-02827NCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Endocrinology, Diabetes & Metabolism CurrentSince Jan 15, 2024 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Jan 15, 2024 Accepting new patients
Caromont Medical Group Inc Endocrinology, Diabetes & Metabolism Current Accepting new patients

Locations

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

2544 Court Dr
Ste A
Gastonia, NC 28054
Phone (704) 671-6400

1200 Village Harbor Dr
Ste C
Lake Wylie, SC 29710
Phone (704) 834-3278

1200 Village Harbor Dr
Ste D
Lake Wylie, SC 29710
Phone (704) 671-6400

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1255828752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 COURT DR STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543450",
            "telephone_number": "704-671-6400",
            "fax_number": "704-671-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADIJA",
        "first_name": "SAIRAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "2023-02827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.