Individual provider Active NPI

Sofia Khandekar, MD

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1649296104
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD010326 Issued in TN
Practice address
1251 Wesley Dr
Suite 100
Memphis, TN 38116-6442
Phone
(901) 396-3061
Fax
(901) 396-7841
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD010326 TN Primary

Addresses

Primary practice location

1251 Wesley Dr
Suite 100
Memphis, TN 38116-6442

Mailing address

1251 Wesley Dr
Suite 100
Memphis, TN 38116-6442
Phone (901) 396-3061

Other identifiers 1

IdentifierTypeStateIssuer
3168542MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD010326TNMDInternal Medicine Physician
10326TNMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1649296104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 WESLEY DR",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166442",
            "telephone_number": "901-396-3061",
            "fax_number": "901-396-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 WESLEY DR",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166442",
            "telephone_number": "901-396-3061",
            "fax_number": "901-396-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDEKAR",
        "first_name": "SOFIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD010326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3168542",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.