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
Last updated
Mar 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 3

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

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

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.

Enrollment records 1

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

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, IncGroup PAC ID 5698689909, 949 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

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Regional Medical Center Incorporated CurrentSince Apr 15, 2021 Accepting new 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
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

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

5130 Parkway Plaza Blvd
Charlotte, NC 28217

Interoperability endpoints

  • Direct secure messaging: gkhan33140@ukhcdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "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.