Organization Active NPI

George G Khouri MD PA

  • Ophthalmic Technician/Technologist
  • West Palm Beach, FL
National Provider Identifier
1457585317
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
ME62262 Issued in FL
Legal business name
GEORGE G KHOURI MD PA
Practice address
1411 N Flagler Dr
Suite 8100
West Palm Beach, FL 33401-3404
Phone
(561) 366-8300
Fax
(561) 366-8320
NPI assigned
May 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Authorized official

Name
Dr. George G Khouri, M.D.NPI 1689683104
Title
President
Phone
(561) 366-8300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X ME62262 FL Primary

Addresses

Primary practice location

1411 N Flagler Dr
Suite 8100
West Palm Beach, FL 33401-3404

Mailing address

1411 N Flagler Dr
Suite 8100
West Palm Beach, FL 33401-3404
Phone (561) 366-8300

Other identifiers 1

IdentifierTypeStateIssuer
374672100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090801000066 FL Part B Supplier - Clinic/Group Practice 8820141278 Receives reassigned benefits from 1 practitioner
Practice locations: Mangonia Park, FL; Palm Beach Gardens, FL; West Palm Beach, FL

National Provider Directory

National Provider Directory

Locations

1411 N Flagler Dr
Ste 8100
West Palm Beach, FL 33401
Phone (561) 366-8300

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1457585317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "address_2": "SUITE 8100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-366-8300",
            "fax_number": "561-366-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "address_2": "SUITE 8100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-366-8300",
            "fax_number": "561-366-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE G KHOURI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "KHOURI",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-366-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "FL",
            "license": "ME62262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374672100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.