NPIMap

Individual provider Active NPI

Khalid Khan, MD

  • Pulmonary Disease Physician
  • Cape Girardeau, MO
National Provider Identifier
1851475669
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
R1D24 Issued in MO
Practice address
#62 Doctors Park
Cape Girardeau, MO 63702-0718
Phone
(573) 335-5359
Fax
(573) 335-2790
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X R1D24 MO Primary

Addresses

Primary practice location

#62 Doctors Park
Cape Girardeau, MO 63702-0718

Mailing address

PO Box 718
#62 Doctors Park
Cape Girardeau, MO 63702-0718
Phone (573) 335-5359

Other identifiers 2

IdentifierTypeStateIssuer
107152OtherMOHEALTHLINK
13262OtherMOBLUE CROSS BLUE SHIELD

Other names 1

  • Khalid Khan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080513000062 MO Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 6800965104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

371 S Broadview St
Cape Girardeau, MO 63703-5761
Phone (573) 331-6710

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Hospital CurrentSince Dec 31, 1991 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Pulmonary Disease CurrentSince Feb 25, 2012 Accepting new patients
Cape Laboratory & Pathology, LC Current Accepting new patients
Southeast Hospital CurrentSince Dec 31, 1991 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

371 S Broadview St
Cape Girardeau, MO 63703
Phone (573) 331-6710

1723 Broadway St
Ste 305
Cape Girardeau, MO 63701

1723 Broadway St
Ste 205
Cape Girardeau, MO 63701
Phone (573) 331-7830

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

62 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 334-4822

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1851475669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 718",
            "address_2": "#62 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637020718",
            "telephone_number": "573-335-5359",
            "fax_number": "573-335-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#62 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637020718",
            "telephone_number": "573-335-5359",
            "fax_number": "573-335-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KHALID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "R1D24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "107152",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "13262",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHALID",
            "last_name": "KHAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.