Khama D Ennis, MD, MPH

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

223355 Issued in MA

Practice address

150 Infirmary Way
Amherst, MA 01003-9288

Phone

(413) 577-5152

NPI assigned

Nov 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Khama D Ennis-Holcombe Former name

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ennis-holcombe.khama.cdh@direct.partners.masshiway.net

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.

• Mass General Brigham Medical Group Western Massachusetts Inc

  • Family Medicine Physician
  • Northampton, MA
  • NPI 1295787919
  Medicare reassignment NPD
• Vineyard Complementary Medicine, Inc

  • Physical Therapy Clinic/Center
  • Edgartown, MA
  • NPI 1053490896
  Medicare reassignment NPD
• Vineyard Complementary Medicine Inc.

  • Chiropractor
  • Edgartown, MA
  • NPI 1821261942
  NPD
• Cooley Dickinson Hospital Inc

  • Urgent Care Clinic/Center
  • Southampton, MA
  • NPI 1932669272
  NPD (past)
• Mass General Brigham Medical Group Western Massachusetts Inc

  • Psychiatry Physician
  • Northampton, MA
  • NPI 1942605373
  NPD (past)

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1669453973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 S PROSPECT ST STE 7",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022268",
            "telephone_number": "413-800-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 INFIRMARY WAY",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010039288",
            "telephone_number": "413-577-5152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 S Prospect St Ste 7",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "MA",
            "postal_code": "010022268",
            "country_code": "US",
            "telephone_number": "413-800-6968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "KHAMA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "223355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHAMA",
            "last_name": "ENNIS-HOLCOMBE",
            "middle_name": "D",
            "prefix": "DR.",
            "credential": "MD, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fred I Eisen, M.A.
• Theodore Jacob Ellenhorn, PHD
• Debra Rudnick Ellis, MSPT, NCS
• Leighann Ellis
• David Alexander Elron
• Rachel Epstein, PSYD
• Casey Anne Erelli, PA-C
• John Burnett Erskine, DPM
• Evelyn Reda, Med Otr Rehab Services, Inc
• Patricia R Everett, PH D

• Emergency Medicine Physician in Amherst, MA
• Providers in Amherst, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.