Shujath Ali Khan MD PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

SHUJATH ALI KHAN MD PC

Practice address

8121 National Ave
Suite 401
Midwest City, OK 73110-7530

Phone

(405) 732-6223

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Susan Walls

Title

Office Manager

Phone

(405) 732-6223

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1861674251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 NATIONAL AVE",
            "address_2": "SUITE 401",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731107530",
            "telephone_number": "405-732-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 NATIONAL AVE",
            "address_2": "SUITE 401",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731107530",
            "telephone_number": "405-732-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHUJATH ALI KHAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "405-732-6223"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861674251",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1861674251",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1861674251",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenna D Shepherd, RBT
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• Lindsey Shipman
• Garrold Dale Sibel, DDS
• Clint Siegersma Siegersma, RBT
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• Joe Angel Silva Jr.
• Rhonda Jan Simmons, R.N.-B.C.

• Gastroenterology Physician in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Gastroenterology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.