Sameena Waheed Khan, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD43967 Issued in TN

Practice address

150 E Swan St
Centerville, TN 37033-1446

Phone

(931) 729-3091

Fax

(931) 729-0809

NPI assigned

Apr 1, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1649442385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E SWAN ST",
            "city": "CENTERVILLE",
            "state": "TN",
            "postal_code": "370331446",
            "telephone_number": "931-729-3091",
            "fax_number": "931-729-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E SWAN ST",
            "city": "CENTERVILLE",
            "state": "TN",
            "postal_code": "370331446",
            "telephone_number": "931-729-3091",
            "fax_number": "931-729-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SAMEENA",
        "middle_name": "WAHEED",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "001615",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD43967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510125",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "3002528",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary McVey Hutchens, M.D.
• Deborah Lee Hutchison, CNA
• Jeannie Marie Kelly, LPC/MHSP
• Karen Denise Kendrick
• Andrew Jarrett Kenney, RD, LDN
• Amanda Lynn King, B.S.
• Mark Allen Landis, MD
• Sheila Darlene Larsen, B. A.
• Wanda Geraldinea Laxton, BSW
• Liberty Pharmacy, Inc

• All providers in Centerville, TN
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.