Individual provider Active NPI

Mahmood A Khan, MD

  • Anesthesiology Physician
  • Little Rock, AR
National Provider Identifier
1417943671
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R2449 Issued in AR
Practice address
11401 Interstate 30
Little Rock, AR 72209-7042
Phone
(501) 455-7100
NPI assigned
Sep 23, 2005
Last updated
Mar 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R2449 AR Primary

Addresses

Primary practice location

11401 Interstate 30
Little Rock, AR 72209-7042

Mailing address

PO Box 22390
Hot Springs, AR 71903-2390
Phone (800) 235-1415

Other identifiers 1

IdentifierTypeStateIssuer
52803OtherARAR BCBS

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 Medicine

State licenses

LicenseStateTypeSpecialty
R2449ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Hospital Association, Inc Past Accepting new patients
Stuttgart Regional Medical Center Past Accepting new patients
Stuttgart Regional Medical Center Past Accepting new patients
Little Rock Outpatient Surgery Center, LLC Past Accepting new patients
Little Rock Outpatient Surgery Center, LLC Past Accepting new patients
Ouachita Regional Anesthesia PLLC Anesthesiology Past Accepting new patients

Organizations & group practices 6

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1417943671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22390",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719032390",
            "telephone_number": "800-235-1415",
            "fax_number": "913-234-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 INTERSTATE 30",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722097042",
            "telephone_number": "501-455-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MAHMOOD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "R2449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "52803",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.