Sandston Primary Care Inc.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

0101053528 Issued in VA

Legal business name

SANDSTON PRIMARY CARE INC.

Practice address

35 E Williamsburg Rd
Sandston, VA 23150-2011

Phone

(804) 737-7804

Fax

(804) 737-8973

NPI assigned

Sep 1, 2006

Last updated

Oct 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shuja U Khan, MD

Title

Owner President

Phone

(804) 737-7804

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Muhammad I Vohra, M.D.

  • Internal Medicine Physician
  • Highland Springs, VA
  • NPI 1720296155
  Medicare reassignment NPD
• Shujauddin Khan, M.D.

  • General Practice Physician
  • Sandston, VA
  • NPI 1114126067
  Medicare reassignment

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602547200000",
    "number": "1265534382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E WILLIAMSBURG RD",
            "city": "SANDSTON",
            "state": "VA",
            "postal_code": "231502011",
            "telephone_number": "804-737-7804",
            "fax_number": "804-737-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E WILLIAMSBURG RD",
            "city": "SANDSTON",
            "state": "VA",
            "postal_code": "231502011",
            "telephone_number": "804-737-7804",
            "fax_number": "804-737-8973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 W Nine Mile Road",
            "address_purpose": "LOCATION",
            "city": "Highland Springs",
            "state": "VA",
            "postal_code": "23075",
            "country_code": "US",
            "telephone_number": "804-737-7804",
            "fax_number": "804-737-8973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANDSTON PRIMARY CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHUJA",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "804-737-7804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "VA",
            "license": "0101053528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "705067",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "454249",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005877814",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• River City Dentistry
• Rochelle Russell
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• S&S Transportation Services LLC
• Sandston Pharmacy
• Ashley Saunders
• Seven Pines Dental Group Sandston LLC
• Kristin Smith, PMHNP, BC
• Courtney Michelle Stith
• David Richard Suyes Jr., DDS

• Preferred Provider Organization in Sandston, VA
• Providers in Sandston, VA by specialty
• Preferred Provider Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.