Individual provider Active NPI

Jeannie Ellen Khane, RN

  • Local Education Agency (LEA)
  • Winslow, AZ
National Provider Identifier
1316124563
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
License
RN139915 Issued in AZ
Practice address
100 Cochise Dr
Winslow, AZ 86047-2072
Phone
(928) 288-8400
Fax
(928) 288-8492
NPI assigned
Jan 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X RN139915 AZ Primary

Addresses

Primary practice location

100 Cochise Dr
Winslow, AZ 86047-2072

Mailing address

800 N Apache Ave
Winslow, AZ 86047-3819
Phone (928) 288-8266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN139915AZMDLocal Education Agency (LEA)

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Unified School District No. 1 Local Education Agency (Lea) Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1316124563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N APACHE AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860473819",
            "telephone_number": "928-288-8266",
            "fax_number": "928-288-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COCHISE DR",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472072",
            "telephone_number": "928-288-8400",
            "fax_number": "928-288-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANE",
        "first_name": "JEANNIE",
        "middle_name": "ELLEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "AZ",
            "license": "RN139915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winslow, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.