Active NPI
Khaishoon N. Basrai, MD
- Internal Medicine Physician
- King, NC
National Provider Identifier
1700865797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 200401615
- Practice address
- 216 Moore Rd
King, NC 27021-8703 - Phone
- (336) 983-4346
- NPI assigned
- Jan 10, 2006
- Sex
- Male
- 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 | 200401615 | NC | Primary |
Addresses
Primary practice location
216 Moore Rd
King, NC 27021-8703
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 718-1000
Other practice location 1
216 Moore Rd
King, NC 27021-8703
Other practice location 2
250 Charlois Blvd
Winston Salem, NC 27103-1508
Phone (336) 718-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5900381 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220308001177 | NC | Order and Referring Only - Internal Medicine | 9739130626 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200401615 | NC | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1700865797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751803",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751803",
"telephone_number": "336-718-1000",
"fax_number": "336-718-1052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 MOORE RD",
"city": "KING",
"state": "NC",
"postal_code": "270218703",
"telephone_number": "336-983-4346"
}
],
"practiceLocations": [
{
"address_1": "216 Moore Rd",
"address_purpose": "LOCATION",
"city": "King",
"state": "NC",
"postal_code": "270218703",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "250 Charlois Blvd",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271031508",
"country_code": "US",
"telephone_number": "336-718-1000",
"fax_number": "336-718-1052",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BASRAI",
"first_name": "KHAISHOON",
"middle_name": "N.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-10",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "200401615",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5900381",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in King, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.