Active NPI
Khaleedah Dannouf, PA-C
- Physician Assistant
- Richmond, VA
National Provider Identifier
1740528827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110004056
- Practice address
- 1201 Broad Rock Blvd
Richmond, VA 23249-0001 - Phone
- (804) 675-5553
- NPI assigned
- Jan 23, 2013
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110004056 | VA | Primary |
Addresses
Primary practice location
1201 Broad Rock Blvd
Richmond, VA 23249-0001
Mailing address
1201 Broad Rock Blvd
Richmond, VA 23249-0001
Phone (804) 675-5553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110004056 | VA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449273600000",
"number": "1740528827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 BROAD ROCK BLVD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232490001",
"telephone_number": "804-675-5553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 BROAD ROCK BLVD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232490001",
"telephone_number": "804-675-5553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANNOUF",
"first_name": "KHALEEDAH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-23",
"last_updated": "2015-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110004056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.