Richmond Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9601645 Issued in NC

Legal business name

RICHMOND PEDIATRICS

Practice address

1219 Rockingham Road
Suite 3
Rockingham, NC 28379

Phone

(910) 895-4140

Fax

(910) 895-4091

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shamsul A Khan, MDNPI 1124347984

Title

Physician Owner

Phone

(910) 895-4140

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shamsul Alam Khan, MD

  • Pediatrics Physician
  • Rockingham, NC
  • NPI 1124347984
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1316008626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 ROCKINGHAM ROAD",
            "address_2": "SUITE 3",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "28379",
            "telephone_number": "910-895-4140",
            "fax_number": "910-895-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 ROCKINGHAM ROAD",
            "address_2": "SUITE 3",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "28379",
            "telephone_number": "910-895-4140",
            "fax_number": "910-895-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHAMSUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "910-895-4140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9601645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1030A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891030A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richmond County Rescue Mission Inc. (Place of Grace)
• Richmond Foot Clinic P.a.
• Richmond Interagency Transportation Inc
• Richmond Internal Medicine and Cardiology Associates PA
• Richmond OB GYN PA
• Richmond Surgical Clinic PA
• Richmond Urology Clinic, PA
• Richmond Womens Center
• Latoya Riley
• Denise Jolynn Rivers, LPN

• Pediatrics Physician in Rockingham, NC
• Providers in Rockingham, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.