Individual provider Active NPI

Khalid Khan, M.D.

  • Internal Medicine Physician
  • Petersburg, VA
National Provider Identifier
1558388199
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12159R Issued in LA
Practice address
200 Medical Park Blvd
Emergency Department
Petersburg, VA 23805-9274
Phone
(804) 765-5000
NPI assigned
Jul 17, 2006
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101230069 VA
Emergency Medicine Physician 207P00000X 37406 WI
Emergency Medicine Physician 207P00000X 12159R LA
Emergency Medicine Physician 207P00000X 36093838 IL
Internal Medicine Physician 207R00000X 12159R LA Primary

Addresses

Primary practice location

200 Medical Park Blvd
Emergency Department
Petersburg, VA 23805-9274

Mailing address

11901 Hogans Aly
Chester, VA 23836-8608
Phone (804) 530-3770

Other identifiers 1

IdentifierTypeStateIssuer
005884942MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, LA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080501000516 VA Practitioner - Internal MedicinePractitioner - Emergency Medicine 5092614107 Reassigns benefits to 5 organizations
I20220601002133 DC Practitioner - Internal Medicine 5092614107 Reassigns benefits to 1 organization
I20230321001321 LA Practitioner - Emergency Medicine 5092614107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1260 Temple Ave
Colonial Heights, VA 23834-2984
Phone (804) 518-2597

6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36093838ILMDEmergency Medicine Physician
12159RLAMDEmergency Medicine Physician
37406WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raceland Emergency Group, LLC Emergency Medicine CurrentSince Oct 15, 2023 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Internal Medicine CurrentSince Mar 6, 2019 Accepting new patients
Western Virginia Regional Emergency Physicians, LLC Emergency Medicine CurrentSince Feb 23, 2022 Accepting new patients
Monroe Emergency Physicians LLC Emergency Medicine CurrentSince Feb 17, 2023 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Dec 1, 2025 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Dec 18, 2019 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Dec 18, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. Internal Medicine CurrentSince Mar 6, 2019 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Virginia Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients

Locations

309 Jackson St
Monroe, LA 71201
Phone (318) 966-4000

4608 Highway 1
Raceland, LA 70394
Phone (504) 537-6841

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 765-5000

727 N Main St
Emporia, VA 23847
Phone (434) 348-4400

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

411 W Randolph Rd
Hopewell, VA 23860
Phone (804) 452-3624

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

245 Medical Park Dr
Marion, VA 24354
Phone (276) 378-1000

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

2 Bernardine Dr
Newport News, VA 23602
Phone (757) 886-6000

100 15th St NW
Norton, VA 24273
Phone (276) 439-1000

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

Interoperability endpoints

  • Direct secure messaging: kkhan5165570@direct.casso.us.com

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1558388199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 HOGANS ALY",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238368608",
            "telephone_number": "804-530-3770",
            "fax_number": "804-530-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059274",
            "telephone_number": "804-765-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KHALID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101230069",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "37406",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "12159R",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "36093838",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "12159R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005884942",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.