Organization Active NPI

Ammar Khalifa, M.D., L.L.C.

  • Internal Medicine Physician
  • Shawnee Mission, KS
National Provider Identifier
1508825878
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-29215 Issued in KS
Legal business name
AMMAR KHALIFA, M.D., L.L.C.
Practice address
8901 W 74TH St
Suite 147
Shawnee Mission, KS 66204-2204
Phone
(913) 432-8400
Fax
(913) 432-8402
NPI assigned
Mar 23, 2006
Last updated
Dec 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Authorized official

Name
Ammar Khalifa, MDNPI 1780677948
Title
President
Phone
(913) 432-8400

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
Internal Medicine Physician 207R00000X 04-29215 KS Primary

Addresses

Primary practice location

8901 W 74TH St
Suite 147
Shawnee Mission, KS 66204-2204

Mailing address

PO Box 932017
Kansas City, MO 64121-2017
Phone (913) 248-9693

Other identifiers 3

IdentifierTypeStateIssuer
200378130AMedicaidKS
501170401MedicaidMO
36903019OtherMOBLUE SHIELD KANSAS CITY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040426000880 MO Part B Supplier - Clinic/Group Practice 1557358348 Receives reassigned benefits from 2 practitioners
Practice locations: Kansas City, MO
O20051029000002 KS Part B Supplier - Clinic/Group Practice 1557358348 Receives reassigned benefits from 4 practitioners
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory
Tax ID family
Ammar Khalifa MD LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11661 College Blvd
Overland Park, KS 66210
Phone (913) 432-8400

8901 W 74th St
Ste 147
Shawnee Msn, KS 66204
Phone (913) 404-5400

8901 Troost Ave
Kansas City, MO 64131
Phone (816) 995-2171

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1508825878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932017",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641212017",
            "telephone_number": "913-248-9693",
            "fax_number": "913-248-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W 74TH ST",
            "address_2": "SUITE 147",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662042204",
            "telephone_number": "913-432-8400",
            "fax_number": "913-432-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMMAR KHALIFA, M.D., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "KHALIFA",
        "authorized_official_first_name": "AMMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-432-8400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-29215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200378130A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501170401",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD KANSAS CITY",
            "identifier": "36903019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.