Active NPI
Taslim A Khattak, M.D.
- Internal Medicine Physician
- Memphis, TN
National Provider Identifier
1679540298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD29699
- Practice address
- 6005 Park Ave Ste 433B
Memphis, TN 38119-5211 - Phone
- (901) 255-1140
- Fax
- (901) 255-1143
- NPI assigned
- Mar 2, 2006
- Last updated
- May 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD29699 | TN | Primary |
Addresses
Primary practice location
6005 Park Ave Ste 433B
Memphis, TN 38119-5211
Mailing address
6005 Park Ave Ste 433B
Memphis, TN 38119-5211
Phone (901) 255-1140
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3724095 | Medicaid | TN | |
| 00121275 | Medicaid | MS | |
| 09016225 | Medicaid | MS | |
| 3821006 | Medicaid | TN | |
| 3144565 | Other | TN | BCBST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
6005 Park Ave
Memphis, TN 38119-5211
Phone (901) 255-1140
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29699 | TN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prime Medical Group, PC | Internal Medicine | Current | Accepting new patients |
| Taslim a Khattak MD | Internal Medicine | Past | Accepting new patients |
| U. S. Rehab Services, Inc | Past | Accepting new patients |
Locations
6005 Park Ave
Ste 433B
Memphis, TN 38119
Phone (877) 734-2233
Interoperability endpoints
- tkhattak34203@mlh.direct-ci.com
- https://api.platform.athenahealth.com/3353/brand/1/csg/1/fhir/r4
- taslim.khattak.1@3353.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Memphis, TN
- NPI 1073624144
-
- Internal Medicine Physician
- Cordova, TN
- NPI 1891943601
-
- Physical Therapy Clinic/Center
- Bartlett, TN
- NPI 1629087374
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1578527172
-
dba Le Bonheur Children's Hospital
- Children's Hospital
- Memphis, TN
- NPI 1386709871
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
-
dba Le Bonheur Children's Hospital - Germantown
- Children's Hospital
- Germantown, TN
- NPI 1649654450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556755200000",
"number": "1679540298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6005 PARK AVE STE 433B",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381195211",
"telephone_number": "901-255-1140",
"fax_number": "901-255-1143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6005 PARK AVE STE 433B",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381195211",
"telephone_number": "901-255-1140",
"fax_number": "901-255-1143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHATTAK",
"first_name": "TASLIM",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-02",
"last_updated": "2019-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "MD29699",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3724095",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00121275",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09016225",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3821006",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBST",
"identifier": "3144565",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.
- 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.