Individual provider Active NPI

Mayuri Lakdawala Khatri, MD

  • Pediatrics Physician
  • Richmond, VA
National Provider Identifier
1790994762
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2012-01761 Issued in NC
Practice address
5801 Bremo Rd
Pediatric Hospitalist
Richmond, VA 23226-1907
Phone
(804) 281-8222
Fax
(804) 281-8007
NPI assigned
May 22, 2007
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101241306 VA
Pediatrics Physician 208000000X 2012-01761 NC Primary

Addresses

Primary practice location

5801 Bremo Rd
Pediatric Hospitalist
Richmond, VA 23226-1907

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Other practice location 1

1515 SW Cary Pkwy Ste 220
Cary, NC 27511-6224
Phone (919) 387-3160

Other identifiers 1

IdentifierTypeStateIssuer
C09463OtherVAGROUP PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkhatri6887@direct.UNC.nchie.net Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211014002387 NC Practitioner - Pediatric Medicine 6800989096 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012-01761NCMDPediatrics Physician
0101241306VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Pediatrics CurrentSince Jul 9, 2021 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients
Rex Hospital Inc Pediatrics Past Accepting new patients
MCV Associated Physicians Pediatrics PastSince Sep 28, 2021 Accepting new patients

Locations

1515 SW Cary Pkwy
Ste 220
Cary, NC 27511
Phone (919) 337-3160

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

Interoperability endpoints

  • Direct secure messaging: mkhatri6887@direct.unc.nchie.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1790994762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "address_2": "PEDIATRIC HOSPITALIST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-281-8222",
            "fax_number": "804-281-8007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 SW Cary Pkwy Ste 220",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275116224",
            "country_code": "US",
            "telephone_number": "919-387-3160",
            "fax_number": "919-387-3165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATRI",
        "first_name": "MAYURI",
        "middle_name": "LAKDAWALA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101241306",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2012-01761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09463",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhatri6887@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1515 SW Cary Pkwy Ste 220",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275116224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.