Fedwa Khalifa, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200200823 Issued in MO

Practice address

930 Kingscove CT
Chesterfield, MO 63017-8350

Phone

(314) 289-6636

Fax

(636) 778-9068

NPI assigned

Aug 17, 2006

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1265545511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6524",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630066524",
            "telephone_number": "314-432-2580",
            "fax_number": "314-432-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 KINGSCOVE CT",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178350",
            "telephone_number": "314-289-6636",
            "fax_number": "636-778-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIFA",
        "first_name": "FEDWA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "200200823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSANCE",
            "identifier": "14009",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "199157",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "H78529",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCUSA",
            "identifier": "55895",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "699445",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "227478",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharine Kerstetter
• Norman Kettner, DC,DACBR
• Key Anesthesia Partners
• Key Autism Services Mo, LLC
• Jessica Marie Keyser
• Jevinne Khan, DC
• Kanwal Khan, M.D.
• Wagmah Javed Khan, MD
• Prajakta Khare, MSC, RDN, LD
• Matthew James Kiblinger, MD

• Family Medicine Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.