Azie Judith Khan

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8079 Issued in MN

Practice address

7211 208TH Cir N
Forest Lake, MN 55025-2903

Phone

(515) 918-3955

NPI assigned

Apr 10, 2021

Last updated

Apr 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• Shalom Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Anoka, MN
  • NPI 1154179778
  Medicare reassignment NPD Authorized official
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Healtheast Medical Research Institute

  dba HealthEast Vadnais Heights Clinic

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment NPD
• Healtheast St. John's Hospital

  dba Fairview St John's Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Medicare reassignment NPD
• Healtheast Woodwinds Hospital

  dba Fairview Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  Medicare reassignment NPD
• Transformation House Inc

  dba Agape Health and Wellness

  • Mental Health Counselor
  • Anoka, MN
  • NPI 1417768771
  Medicare reassignment NPD
• Mount Zion Care Services LLC

  • Assisted Living Facility (Mental Illness)
  • Anoka, MN
  • NPI 1700519741
  NPD Authorized official
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  dba Fairview Clinics-Andover

  • Multi-Specialty Clinic/Center
  • Andover, MN
  • NPI 1477734705
  NPD
• Fairview Express Care

  dba University of Minnesota Physicians Heart at Fairview

  • Cardiovascular Disease Physician
  • Edina, MN
  • NPI 1710133343
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618012800000",
    "number": "1265012629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 208TH CIR N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252903",
            "telephone_number": "515-918-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 208TH CIR N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252903",
            "telephone_number": "515-918-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AZIE",
        "middle_name": "JUDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-10",
        "last_updated": "2021-04-10",
        "certification_date": "2021-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Clinic of Chiropractic, P.a.
• Mark W Kari, D.C.
• Jack Kasl, PH.D.
• Tammy Kasprowicz, PT
• Steven Kennedy
• Krista Kirby, MA
• Donald Wayne Kjome, M.D.
• Sarah Marie Klein, PT, DPT
• Abbygayle Rose Knutson
• Linda E Kordosky, LMFT

• Psychiatric/Mental Health Nurse Practitioner in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2021; 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.