NPIMap

Organization Active NPI

Amarillo Urgent Care LLC

  • Family Medicine Physician
  • Amarillo, TX
National Provider Identifier
1881895050
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AMARILLO URGENT CARE LLC
Practice address
1915 S Coulter St
Amarillo, TX 79106
Phone
(806) 354-2378
NPI assigned
May 29, 2007
Last updated
Aug 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Authorized official

Name
Naeem U KhanNPI 1316990765
Title
MD
Phone
(806) 354-2378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1915 S Coulter St
Amarillo, TX 79106

Mailing address

1915 S Coulter St
Amarillo, TX 79106-1780
Phone (806) 354-2378

Other identifiers 1

IdentifierTypeStateIssuer
190627301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071029000148 TX Part B Supplier - Clinic/Group Practice 4981791613 Receives reassigned benefits from 19 practitioners
Practice locations: Amarillo, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1079019Amarillo Urgent Care1915 S Coulter, Amarillo, TX 79106Certificate of waiverMar 14, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1881895050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061780",
            "telephone_number": "806-354-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79106",
            "telephone_number": "806-354-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARILLO URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "NAEEM",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "806-354-2378"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190627301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.