Individual provider Active NPI

Asra Unnisa-Khan Khaliq, D.C

  • Chiropractor
  • Lakeland, FL
National Provider Identifier
1356887459
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13255 Issued in TX
Practice address
5100 US Highway 98 N Ste 16
Lakeland, FL 33809-0504
Phone
(863) 859-5441
NPI assigned
Jan 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12696 FL
Chiropractor 111N00000X 13255 TX Primary

Addresses

Primary practice location

5100 US Highway 98 N Ste 16
Lakeland, FL 33809-0504

Mailing address

5100 US Highway 98 N Ste 16
Lakeland, FL 33809-0504
Phone (863) 859-5441

Other practice location 1

6660 Airline Dr
Houston, TX 77076-3512
Phone (713) 697-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211014000342 FL Practitioner - Chiropractic 2769880251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5100 US Hwy 98 N
Suite 16
Lakeland, FL 33809-0504
Phone (863) 859-5441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH12696FLMDChiropractor
13255TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Care Injury Clinic, LLC Chiropractor CurrentSince Aug 9, 2021 Accepting new patients
Paul M Romine PA North Lakeland Chiropractic Chiropractor PastSince Aug 9, 2021 Accepting new patients

Locations

5100 US Highway 98 N
Ste 16
Lakeland, FL 33809
Phone (863) 859-5441

Organizations & group practices 2

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": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1356887459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 US HIGHWAY 98 N STE 16",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338090504",
            "telephone_number": "863-859-5441",
            "fax_number": "713-697-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 US HIGHWAY 98 N STE 16",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338090504",
            "telephone_number": "863-859-5441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6660 Airline Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770763512",
            "country_code": "US",
            "telephone_number": "713-697-8000",
            "fax_number": "713-697-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALIQ",
        "first_name": "ASRA",
        "middle_name": "UNNISA-KHAN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12696",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.