NPIMap

Individual provider Active NPI

Jamshed K Khan, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Lumberton, NC
National Provider Identifier
1659378263
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
200300054 Issued in NC
Practice address
395 W 27TH St
Lumberton, NC 28358-3018
Phone
(910) 739-7551
Fax
(910) 739-2332
NPI assigned
Jun 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 200300054 NC Primary
Internal Medicine Physician 207R00000X 200300054 NC

Addresses

Primary practice location

395 W 27TH St
Lumberton, NC 28358-3018

Mailing address

395 W 27TH St
Lumberton, NC 28358-3018
Phone (910) 739-7551

Other identifiers 1

IdentifierTypeStateIssuer
89133Y2MedicaidNC

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Regional Medical Center Past Accepting new patients
Southeastern Regional Medical Center Past Accepting new patients
Southeastern Regional Medical Center Past Accepting new patients
Rex Hospital Inc Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients

Organizations & group practices 5

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": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1659378263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583018",
            "telephone_number": "910-739-7551",
            "fax_number": "910-739-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583018",
            "telephone_number": "910-739-7551",
            "fax_number": "910-739-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "JAMSHED",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "200300054",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200300054",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89133Y2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.