Internal Medicine & Nephrology Associates, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

23879 Issued in OK

Legal business name

INTERNAL MEDICINE & NEPHROLOGY ASSOCIATES, PC

Practice address

105 S Bryant Ave
202
Edmond, OK 73034-6399

Phone

(405) 340-4565

Fax

(405) 340-4583

NPI assigned

May 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mohammad Fazel Khalili, M.D.NPI 1508807389

Title

Owner

Phone

(405) 340-4565

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Mohammad Fazel Khalili, MD

  • Internal Medicine Physician
  • Edmond, OK
  • NPI 1508807389
  NPD (past) Authorized official
• Viorica Khalili, MD

  • Nephrology Physician
  • Edmond, OK
  • NPI 1003858663
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619923281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S BRYANT AVE",
            "address_2": "202",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346399",
            "telephone_number": "405-340-4565",
            "fax_number": "405-340-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BRYANT AVE",
            "address_2": "202",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346399",
            "telephone_number": "405-340-4565",
            "fax_number": "405-340-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE & NEPHROLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHALILI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "FAZEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-340-4565",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "23879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "342965190002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integris Health Edmond, Inc (INTEGRIS Health Edmond Hospital)
• Integris Prohealth Inc (INTEGRIS Pharmacy 4187)
• Integrity Counseling & Consulting Services LLC
• Integrity Home Health Services
• Intentional Lives Therapy
• Intrepid Home Care of Oklahoma
• Sofia Iqbal, MD
• Michael McClain Irby
• Trinidy Makayla Elizabeth Irvin
• Susan Lee Isaacs, D.PH.

• Internal Medicine Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.