Hagerstown Psychiatry Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

HAGERSTOWN PSYCHIATRY INC

Practice address

12821 Oak Hill Ave Ste 3
Hagerstown, MD 21742-2959

Phone

(240) 452-1623

Fax

(240) 597-6620

NPI assigned

Feb 20, 2019

Organization subpart

No

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

Authorized official

Name

Shahnoor Khan, MDNPI 1346342458

Title

President

Phone

(703) 400-3433

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shahnoor Ali Khan, MD

  • Psychiatry Physician
  • Martinsburg, WV
  • NPI 1346342458

  MD

  Medicare reassignment NPD Authorized official
• Carole Tchatchoua, CRNP-F

  • Psychiatric/Mental Health Nurse Practitioner
  • Hagerstown, MD
  • NPI 1447718549

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1730646290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11123 COROBON LN",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220661403",
            "telephone_number": "304-279-9772",
            "fax_number": "703-763-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12821 OAK HILL AVE STE 3",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422959",
            "telephone_number": "240-452-1623",
            "fax_number": "240-597-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGERSTOWN PSYCHIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-20",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHAHNOOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-400-3433",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "D0064888",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hagerstown Integrative Mental Health
• Hagerstown Management LLC
• Hagerstown Nursing and Rehab Center LLC
• Hagerstown Pediatrics
• Hagerstown Prime Dental
• Hagerstown Reproductive Health Services
• Hagerstown Smiles Dental Care, PA
• Hagerstown Surgery Center,LLC
• Hagertown Dental Center
• Lauren Taylor Haines, DPT,PT

• Psychiatry Physician in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.