Individual provider Active NPI

Fatima Hasan Khan, D.O

  • Internal Medicine Physician
  • Florence, AZ
National Provider Identifier
1881914034
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
007642 Issued in AZ
Practice address
5653 W Valor Way
Florence, AZ 85132-1313
Phone
(816) 888-9382
NPI assigned
Jun 9, 2010
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
007642AZMDInternal Medicine Physician
05-37715KSMDInternal 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.

Verify at the official NPI Registry.