Poonam Khanna, D.O.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

05-29535 Issued in KS

Practice address

14221 Metcalf Ave
Suite 123
Overland Park, KS 66223-3344

Phone

(913) 912-7054

NPI assigned

Jan 11, 2007

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1306996434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14221 METCALF AVE",
            "address_2": "SUITE 123",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233344",
            "telephone_number": "913-912-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14221 METCALF AVE",
            "address_2": "SUITE 123",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233344",
            "telephone_number": "913-912-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANNA",
        "first_name": "POONAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KS",
            "license": "05-29535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "260050357",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "31650014",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100421600A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO MEDICAID",
            "identifier": "245887708",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manoj Kumar Khamuani, M.D.
• Khan Eyelid and Facial Plastic Surgery LLC
• Ambreen Nasir Khan, MD
• Jemshed A Khan, M.D.
• Shareen Khani, APRN
• Olivia Khazan, R. PH., PHARMD
• Allison Michelle Kidd, LMSW
• Kenneth Wayne Kidd
• Mitchell Kidd, PT, DPT
• Sarah Kidder, LMSW

• Child & Adolescent Psychiatry Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Child & Adolescent Psychiatry Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.