NPIMap

Individual provider Active NPI

Gulam Qutubuddin Khan, MD

  • Child & Adolescent Psychiatry Physician
  • Lexington, KY
National Provider Identifier
1578697348
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
40701 Issued in KY
Practice address
740 S Limestone
J 401
Lexington, KY 40536-4012
Phone
(859) 323-5661
Fax
(859) 257-4999
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 11

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, Inc 949 clinicians
Ephraim McDowell Regional Medical Center Incorporated 40 clinicians

Practice addresses (Care Compare)

100 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 257-9800

217 S 3Rd St
Danville, KY 40422-1823
Phone (859) 239-2318

2400 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 323-7426

Hospital & facility affiliations

  • University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067
  • Ephraim McDowell Regional Medical Center Hospital, Danville, KY, CCN 180048

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20071128000083 KY Practitioner - Neurology 3072602127 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40701KYMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Neurology CurrentSince Mar 2, 2007 Accepting new patients
Ephraim McDowell Regional Medical Center Incorporated CurrentSince Apr 15, 2021 Accepting new patients
Ephraim McDowell Regional Medical Center, Incorporated CurrentSince Apr 15, 2021 Accepting new patients
University of Kentucky Past Accepting new patients

Locations

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

2195 Harrodsburg Rd
Ste 2
Lexington, KY 40504
Phone (859) 323-8082

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

5130 Parkway Plaza Blvd
Charlotte, NC 28217

Interoperability endpoints

  • Direct secure messaging: gkhan33140@ukhcdirect.org

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 40701 KY
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 40701 KY
Child & Adolescent Psychiatry Physician 2084P0804X 40701 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

740 S Limestone
J 401
Lexington, KY 40536-4012

Mailing address

740 S Limestone
J 401
Lexington, KY 40536-4012
Phone (859) 323-5661

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 12, 2019.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1578697348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "J 401",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405364012",
            "telephone_number": "859-323-5661",
            "fax_number": "859-257-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "J 401",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405364012",
            "telephone_number": "859-323-5661",
            "fax_number": "859-257-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "GULAM",
        "middle_name": "QUTUBUDDIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "40701",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "KY",
            "license": "40701",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "40701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.