Individual provider Active NPI

Uzma Waheed Khan, MS; RD; LD

  • Registered Dietitian
  • Allen, TX
National Provider Identifier
1649459405
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT07722 Issued in TX
Practice address
1020 W Exchange Pkwy Ste 2160
Allen, TX 75013-7115
Phone
(469) 471-1988
Fax
(866) 450-9391
NPI assigned
Oct 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT07722 TX Primary

Addresses

Primary practice location

1020 W Exchange Pkwy Ste 2160
Allen, TX 75013-7115

Mailing address

1020 W Exchange Pkwy Ste 2160
Allen, TX 75013-7115
Phone (469) 471-1988

Other identifiers 2

IdentifierTypeStateIssuer
360330001MedicaidTX
4650462OtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160105002883 TX Practitioner - Registered Dietitian Or Nutrition Professional 7517269731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1020 W Exchange Pkwy
Suite 160
Allen, TX 75013-7027
Phone (972) 332-8866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Up4 Nutrition LLC Dietitian, Registered CurrentSince Mar 10, 2016 Accepting new patients

Locations

1020 W Exchange Pkwy
Ste 160
Allen, TX 75013
Phone (972) 332-8866

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FJEGCD/Endpoint/FJEGCD

Organizations & group practices 1

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1649459405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 W EXCHANGE PKWY STE 2160",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750137115",
            "telephone_number": "469-471-1988",
            "fax_number": "866-450-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W EXCHANGE PKWY STE 2160",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750137115",
            "telephone_number": "469-471-1988",
            "fax_number": "866-450-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "UZMA",
        "middle_name": "WAHEED",
        "name_prefix": "Mrs.",
        "credential": "MS; RD; LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT07722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360330001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "4650462",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.