Nooshazar Khalvati - Khosravi, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME41780 Issued in FL

Practice address

4123 University Blvd S
Suite E.
Jacksonville, FL 32216-4371

Phone

(904) 731-5437

Fax

(904) 733-6776

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Nooshazar Khalvati Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1306990387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 UNIVERSITY BLVD S",
            "address_2": "SUITE E.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164371",
            "telephone_number": "904-731-5437",
            "fax_number": "904-733-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 UNIVERSITY BLVD S",
            "address_2": "SUITE E.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164371",
            "telephone_number": "904-731-5437",
            "fax_number": "904-733-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALVATI - KHOSRAVI",
        "first_name": "NOOSHAZAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME41780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "15839",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOOSHAZAR",
            "last_name": "KHALVATI",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Luna I Khadour, M.D.
• Jay Khadpe, M.D.
• Masarra Khalaf
• Rawan Isameldin Abdelaal Khalid
• Hamid-U-Rahman Khalili, ARNP
• Ibrahim Khambati, MD, MBA
• Adil Arshad Khan, MD
• Ammar A Khan, DDS
• Aruna Khan, MD
• Ateeque R. Khan, M.D.

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.