Active NPI
Raja B Khan, MD
- Neurology Physician
- Memphis, TN
National Provider Identifier
1366445454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 34758
- Practice address
- 262 Danny Thomas PL
Memphis, TN 38105-3678 - Phone
- (901) 595-3006
- Fax
- (901) 595-3842
- NPI assigned
- May 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 34758 | TN | Primary |
Addresses
Primary practice location
262 Danny Thomas PL
Memphis, TN 38105-3678
Mailing address
262 Danny Thomas PL
Ms 515
Memphis, TN 38105-3678
Phone (901) 595-3006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3899188 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060621000195 | TN | Practitioner - Neurology | 9830101542 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Jude Children'S Research Hospital, Inc. | Current | Accepting new patients | |
| Ozarks Medical Center | Neurology | Past | Accepting new patients |
| Neurology Clinic, PC | Neurology | Past | Accepting new patients |
| Neurology Clinic, PC | Neurology | Past | Accepting new patients |
Locations
262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343
262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006
Organizations & group practices 4
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.
-
- Durable Medical Equipment & Medical Supplies
- Cordova, TN
- NPI 1538798558
Neurology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462752000000",
"number": "1366445454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"address_2": "MS 515",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3006",
"fax_number": "901-595-3842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3006",
"fax_number": "901-595-3842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "RAJA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2016-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TN",
"license": "34758",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3899188",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.