Active NPI
Fazila Khaliq, MD
- Internal Medicine Physician
- Southaven, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 21279
- Practice address
- 7601 Southcrest Parkway
Southaven, MS 38671 - Phone
- (662) 772-2980
- Fax
- (662) 772-2960
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | E-14405 | AR | |
| Internal Medicine Physician | 207R00000X | 49063 | TN | |
| Internal Medicine Physician | 207R00000X | 21279 | MS | Primary |
Addresses
Primary practice location
7601 Southcrest Parkway
Southaven, MS 38671
Mailing address
965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401
Other practice location 1
6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-3610
Other practice location 2
2100 N 7th St
West Memphis, AR 72301-2017
Phone (901) 226-3610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS, TN, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
255 Baptist Blvd
Columbus, MS 39705-2006
5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-1000
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-2130
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.87 of 100
- Quality
- 64.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.81
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-14405 | AR | MD | Internal Medicine Physician |
| 21279 | MS | MD | Internal Medicine Physician |
| 49063 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Memorial Medical Group Inc | Current | Accepting new patients | |
| Southeastern Physician Services PC | Internal Medicine | Current | Accepting new patients |
| Baptist Memorial Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Greenbrook Physician Services, LLC | Internal Medicine | Current | Accepting new patients |
| Baptist Memorial Hospital-Desoto, Inc, | Past | Accepting new patients |
Locations
4802 E Johnson Ave
Jonesboro, AR 72405
Phone (901) 227-9820
2100 N 7th St
West Memphis, AR 72301
Phone (870) 394-7800
255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288
7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000
36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801
965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221
6225 Humphreys Blvd
Memphis, TN 38120
Phone (901) 227-2727
6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190
965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281
5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Southaven, MS
- NPI 1801683008
-
- Hospitalist Physician
- Oak Ridge, TN
- NPI 1083835441
Internal Medicine
-
- Community/Retail Pharmacy
- Memphis, TN
- NPI 1841006129
-
- General Acute Care Hospital
- Southaven, MS
- NPI 1194789818
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Southaven, MS
- NPI 1194789818
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1952326977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629072000000",
"number": "1467671677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "965 RIDGE LAKE BLVD STE 315",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381209401",
"fax_number": "901-227-8591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7601 SOUTHCREST PARKWAY",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "38671",
"telephone_number": "662-772-2980",
"fax_number": "662-772-2960"
}
],
"practiceLocations": [
{
"address_1": "6019 Walnut Grove Rd",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381202113",
"country_code": "US",
"telephone_number": "901-226-3610",
"fax_number": "901-226-3612",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2100 N 7th St",
"address_purpose": "LOCATION",
"city": "West Memphis",
"state": "AR",
"postal_code": "723012017",
"country_code": "US",
"telephone_number": "901-226-3610",
"fax_number": "901-226-3612",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHALIQ",
"first_name": "FAZILA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2021-08-16",
"certification_date": "2021-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AR",
"license": "E-14405",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "49063",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "21279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.