Individual provider Active NPI

Nasim A Khan

  • Rheumatology Physician
  • Little Rock, AR
National Provider Identifier
1710909098
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
E-5873 Issued in AR
Practice address
10001 Lile Dr
Little Rock, AR 72205-6217
Phone
(501) 552-0500
Fax
(501) 604-8758
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X E-5873 AR Primary

Addresses

Primary practice location

10001 Lile Dr
Little Rock, AR 72205-6217

Mailing address

PO Box 23410
Little Rock, AR 72221-3410
Phone (501) 224-1690

Other practice location 1

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other identifiers 2

IdentifierTypeStateIssuer
1I8763OtherARMEDICARE ID FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC
177897001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20090708000226 AR Practitioner - RheumatologyPractitioner - Internal Medicine 8325062169 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Internal Medicine Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2009 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2009 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients
Heart Center of Southern Maryland, L.L.P. Past Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

Interoperability endpoints

  • Direct secure messaging: nasim.khan.p1@direct.chi-lrdc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1710909098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23410",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722213410",
            "telephone_number": "501-224-1690",
            "fax_number": "501-224-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 LILE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056217",
            "telephone_number": "501-552-0500",
            "fax_number": "501-604-8758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 783",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NASIM",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AR",
            "license": "E-5873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC",
            "identifier": "1I8763",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177897001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.