NPIMap

Individual provider Active NPI

Ralph A Khan, D.O.

  • Diagnostic Radiology Physician
  • Cherry Hill, NJ
National Provider Identifier
1396789038
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS006713L Issued in PA
Practice address
142 Valley Run Dr
Cherry Hill, NJ 08002-3024
Phone
(856) 354-6006
NPI assigned
Jun 15, 2006
Last updated
Jan 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X OS006713L PA
Neuroradiology Physician 2085N0700X OS006713L PA
Nuclear Radiology Physician 2085N0904X OS006713L PA
Diagnostic Radiology Physician 2085R0202X OS006713L PA Primary
Vascular & Interventional Radiology Physician 2085R0204X OS006713L PA
Diagnostic Ultrasound Physician 2085U0001X OS006713L PA

Addresses

Primary practice location

142 Valley Run Dr
Cherry Hill, NJ 08002-3024

Mailing address

142 Valley Run Dr
Cherry Hill, NJ 08002-3024
Phone (856) 354-6006

Other identifiers 1

IdentifierTypeStateIssuer
0012239500MedicaidPA

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)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS006713LPAMDBody Imaging Physician
1981WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lebanon Imaging Associates, PC Body Imaging Past Accepting new patients
SSP Partners, LLC Past Accepting new patients
Raytel Medical Imaging, Inc. Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1396789038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 VALLEY RUN DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080023024",
            "telephone_number": "856-354-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 VALLEY RUN DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080023024",
            "telephone_number": "856-354-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RALPH",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "PA",
            "license": "OS006713L",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "OS006713L",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "OS006713L",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "OS006713L",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "OS006713L",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "PA",
            "license": "OS006713L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012239500",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.