Individual provider Active NPI

Khalid Chaudry, M.D.

  • Internal Medicine Physician
  • Corbin, KY
National Provider Identifier
1306895966
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21165 Issued in KY
Practice address
15 Moonbow PLZ
Corbin, KY 40701-8949
Phone
(606) 528-5331
Fax
(606) 528-3223
NPI assigned
May 9, 2006
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21165 KY Primary
Cardiovascular Disease Physician 207RC0000X 21165 KY

Addresses

Primary practice location

15 Moonbow PLZ
Corbin, KY 40701-8949

Mailing address

PO Box 1325
Corbin, KY 40702-1325
Phone (606) 526-8131

Other identifiers 3

IdentifierTypeStateIssuer
64211659MedicaidKY
C04002OtherKYCHI
P01434922OtherKYRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kchaudry6312@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20041013000108 KY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3375503568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1 Trillium Way
MTM/DSM
Corbin, KY 40701-8727
Phone (606) 526-4647

15 Moonbow PLZ
Corbin, KY 40701-8949
Phone (606) 528-5331

4071 Tates Creek Centre Dr
Suite 202
Lexington, KY 40517-3094
Phone (859) 260-4390

45 Moonbow PLZ
Corbin, KY 40701-8949
Phone (606) 523-9010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21165KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jan 1, 2015 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jan 1, 2015 Accepting new patients
Eagle Health & Wellness, Inc. Past Accepting new patients
Corbin Cardiology & Internal Medicine, Inc. PastSince Oct 12, 2004 Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1 Trillium Way
Ste 301
Corbin, KY 40701
Phone (606) 526-7363

15 Moonbow Plz
Corbin, KY 40701
Phone (606) 528-4481

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

Interoperability endpoints

  • Direct secure messaging: kchaudry6312@bhkydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1306895966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1325",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407021325",
            "telephone_number": "606-526-8131",
            "fax_number": "606-528-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MOONBOW PLZ",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018949",
            "telephone_number": "606-528-5331",
            "fax_number": "606-528-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDRY",
        "first_name": "KHALID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "21165",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "21165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64211659",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHI",
            "identifier": "C04002",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01434922",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchaudry6312@bhkydirect.com",
            "affiliation": "N",
            "address_1": "15 Moonbow Plz",
            "city": "Corbin",
            "state": "KY",
            "country_code": "US",
            "postal_code": "407018949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.