NPIMap

Individual provider Active NPI

Samira M Khan, MD

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1427344720
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52021 Issued in TN
Practice address
1300 Wesley Dr
Memphis, TN 38116-6426
Phone
(901) 395-2618
Fax
(901) 385-3261
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 52021 TN
Internal Medicine Physician 207R00000X 52021 TN Primary

Addresses

Primary practice location

1300 Wesley Dr
Memphis, TN 38116-6426

Mailing address

P O Box 1000 Dept 351
Memphis, TN 38148-0001
Phone (901) 395-2618

Other identifiers 3

IdentifierTypeStateIssuer
6139666OtherTNBCBS
Q012877MedicaidTN
09722713MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150601002815 TN Practitioner - Internal MedicinePractitioner - Hospitalist 2365763471 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Havely Springs Physician Services PCGroup PAC ID 3678934726, 63 clinicians
Williamson Hospitalist ProgramGroup PAC ID 0042553158, 42 clinicians

Practice addresses (Care Compare)

1700 Medical Ctr Pkwy
Murfreesboro, TN 37129-2245
Phone (615) 396-4100

4321 Carothers Pkwy
Franklin, TN 37067-5909
Phone (615) 495-6700

Hospital & facility affiliations

  • Saint Thomas Rutherford Hospital Hospital, Murfreesboro, TN, CCN 440053
  • Williamson Medical Center Hospital, Franklin, TN, CCN 440029
  • Southern Tennessee Regional Health System Winchest Hospital, Winchester, TN, CCN 440058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Williamson Hospitalist Program Hospitalist CurrentSince Dec 1, 2024 Accepting new patients
Saint Thomas Medical Partners Internal Medicine CurrentSince Feb 16, 2015 Accepting new patients
Havely Springs Physician Services, PC Hospitalist CurrentSince Aug 15, 2023 Accepting new patients
Saint Thomas Rutherford Hospital Past Accepting new patients

Locations

4321 Carothers Pkwy
Franklin, TN 37067
Phone (615) 435-5000

1700 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 396-4100

300 20th Ave N
Fl 9
Nashville, TN 37203

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1427344720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1000 DEPT 351",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-395-2618",
            "fax_number": "901-385-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 WESLEY DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166426",
            "telephone_number": "901-395-2618",
            "fax_number": "901-385-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SAMIRA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "52021",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "52021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6139666",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q012877",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09722713",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.