NPIMap

Individual provider Active NPI

Ghulam Mohammed Khaleel, MD

  • Clinical Neurophysiology Physician
  • White Hall, AR
National Provider Identifier
1669486007
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
E4456 Issued in AR
Practice address
105 Frankie LN
White Hall, AR 71605-3027
Phone
(870) 247-6160
Fax
(870) 247-6167
NPI assigned
Jul 29, 2006
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X E4456 AR Primary

Addresses

Primary practice location

105 Frankie LN
White Hall, AR 71605-3027

Mailing address

105 Frankie LN
White Hall, AR 71602-2685
Phone (870) 247-6160

Other identifiers 1

IdentifierTypeStateIssuer
5N367OtherARBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011001076 AR Practitioner - Neurology 6305861048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurology Clinic of South Arkansas,PAGroup PAC ID 5698790335, 2 clinicians

Practice addresses (Care Compare)

105 Frankie LN
White Hall, AR 71602-2685
Phone (870) 247-6160

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Clinic of South Arkansas,PA CurrentSince Jul 11, 2005 Accepting new patients
American Hope and Health Clinic Associates LLC CurrentSince Feb 1, 2022 Accepting new patients
Charis Health & Wellness PastSince Apr 11, 2019 Accepting new patients
Advocate Health Centers, Inc. Past Accepting new patients
Crossett Health Foundation Past Accepting new patients
Crossett Health Foundation Past Accepting new patients

Locations

1015 Unity Rd
#400
Crossett, AR 71635
Phone (870) 364-1272

714 W Faulkner St
El Dorado, AR 71730
Phone (870) 862-5184

100 Shadow Oaks Dr
Sherwood, AR 72120
Phone (501) 918-9192

105 Frankie Ln
White Hall, AR 71602
Phone (870) 247-2088

7500 Dollarway Rd
Ste 106
White Hall, AR 71602
Phone (870) 247-6160

7500 Dollarway Rd
Ste 403
White Hall, AR 71602
Phone (870) 247-4525

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1669486007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FRANKIE LN",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022685",
            "telephone_number": "870-247-6160",
            "fax_number": "870-247-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 FRANKIE LN",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716053027",
            "telephone_number": "870-247-6160",
            "fax_number": "870-247-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALEEL",
        "first_name": "GHULAM",
        "middle_name": "MOHAMMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "AR",
            "license": "E4456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5N367",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Hall, AR

Sources for this page

Verify at the official NPI Registry.