Individual provider Active NPI

Romesh K. Khardori, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Norfolk, VA
National Provider Identifier
1811984602
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0101249674 Issued in VA
Practice address
855 W Brambleton Ave
Norfolk, VA 23510-1005
Phone
(757) 446-5908
Fax
(757) 446-7055
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0101249674 VA Primary

Addresses

Primary practice location

855 W Brambleton Ave
Norfolk, VA 23510-1005

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-5908

Other identifiers 14

IdentifierTypeStateIssuer
1811984602OtherVAUNITED HEALTHCARE/MAMSI
PAROtherVAUSA MANAGED CARE
PAROtherVACIGNA
-033OtherVATRICARE/CHAMPUS
10080949OtherVAOPTIMA HEALTH
PAROtherVAAETNA
5918376MedicaidNC
PAROtherVACORVEL
1811984602OtherVAFIRST HEALTH NETWORK/SOUTHERN HEALTH/COVENTRY NATIONAL
1811984602MedicaidVA
PAROtherVAMULTIPLAN
1811984602OtherVAVIRGINIA PREMIER HEALTH PLAN
442639OtherVAANTHEM BC/BS
PAROtherVAVIRGINIA HEALTH NETWORK

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101249674VAMDEndocrinology, Diabetes & Metabolism Physician

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1811984602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-5908",
            "fax_number": "757-446-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 W BRAMBLETON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101005",
            "telephone_number": "757-446-5908",
            "fax_number": "757-446-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHARDORI",
        "first_name": "ROMESH",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101249674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE/MAMSI",
            "identifier": "1811984602",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "-033",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "10080949",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918376",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK/SOUTHERN HEALTH/COVENTRY NATIONAL",
            "identifier": "1811984602",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811984602",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "PAR",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH PLAN",
            "identifier": "1811984602",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "442639",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "PAR",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.