Active NPI
Fatima Hasan Khan, D.O
- Internal Medicine Physician
- Florence, AZ
National Provider Identifier
1881914034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 007642
- Practice address
- 5653 W Valor Way
Florence, AZ 85132-1313 - Phone
- (816) 888-9382
- NPI assigned
- Jun 9, 2010
- Last updated
- Jun 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 007642 | AZ | Primary |
| Internal Medicine Physician | 207R00000X | 05-37715 | KS |
Addresses
Primary practice location
5653 W Valor Way
Florence, AZ 85132-1313
Mailing address
5653 W Valor Way
Florence, AZ 85132-1313
Phone (816) 888-9382
Other practice location 1
315 S Osteopathy Ave
DME office
Kirksville, MO 63501-6401
Phone (660) 785-1557
Other practice location 2
2201 W 25th St Ste U
Lawrence, KS 66047-2957
Phone (785) 371-1307
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007642 | AZ | MD | Internal Medicine Physician |
| 05-37715 | KS | MD | Internal Medicine Physician |
Organizations & group practices 1
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": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1881914034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5653 W VALOR WAY",
"city": "FLORENCE",
"state": "AZ",
"postal_code": "851321313",
"telephone_number": "816-888-9382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5653 W VALOR WAY",
"city": "FLORENCE",
"state": "AZ",
"postal_code": "851321313",
"telephone_number": "816-888-9382"
}
],
"practiceLocations": [
{
"address_1": "315 S Osteopathy Ave",
"address_2": "DME office",
"address_purpose": "LOCATION",
"city": "Kirksville",
"state": "MO",
"postal_code": "635016401",
"country_code": "US",
"telephone_number": "660-785-1557",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2201 W 25th St Ste U",
"address_purpose": "LOCATION",
"city": "Lawrence",
"state": "KS",
"postal_code": "660472957",
"country_code": "US",
"telephone_number": "785-371-1307",
"fax_number": "785-380-1307",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAN",
"first_name": "FATIMA",
"middle_name": "HASAN",
"name_prefix": "Dr.",
"credential": "D.O",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-09",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "007642",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KS",
"license": "05-37715",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Florence, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.