Individual provider Active NPI

Khalid Iqbal, MD

  • Gastroenterology Physician
  • Somerset, KY
National Provider Identifier
1447349329
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
23896 Issued in KY
Practice address
110 Hardin LN
Suite 9
Somerset, KY 42503-3818
Phone
(606) 679-7317
NPI assigned
Oct 11, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 23896 KY Primary

Addresses

Primary practice location

110 Hardin LN
Suite 9
Somerset, KY 42503-3818

Mailing address

110 Hardin LN
Suite 9
Somerset, KY 42503-3818
Phone (606) 679-7317

Other identifiers 1

IdentifierTypeStateIssuer
64238967MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000896 KY Practitioner - Gastroenterology 5294828067 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23897KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Physician Practices LLC Gastroenterology CurrentSince Oct 1, 2019 Accepting new patients
Lake Cumberland Physician Practices, LLC CurrentSince Oct 1, 2019 Accepting new patients

Locations

103 Hardin Ln
Ste A
Somerset, KY 42503
Phone (606) 451-0300

110 Hardin Ln
Ste 9
Somerset, KY 42503
Phone (606) 679-7316

30 Tower Cir
Somerset, KY 42503
Phone (606) 451-8644

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

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, 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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1447349329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN",
            "address_2": "SUITE 9",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-679-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN",
            "address_2": "SUITE 9",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-679-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "KHALID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "23896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64238967",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.