NPIMap

Individual provider Active NPI

Faddy Imad Khamis, MD

  • Internal Medicine Physician
  • Olathe, KS
National Provider Identifier
1891288338
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-45075 Issued in KS
Practice address
20805 W 151St St Ste 224
Olathe, KS 66061-7249
Phone
(913) 355-8400
Fax
(913) 782-1574
NPI assigned
Jun 10, 2018
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04-45075 KS Primary

Addresses

Primary practice location

20805 W 151St St Ste 224
Olathe, KS 66061-7249

Mailing address

20805 W 151St St Ste 224
Olathe, KS 66061-7249
Phone (913) 355-8400

Other names 1

  • Dr. Faddy Imad Khamis Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20210915000524 KS Practitioner - Internal Medicine 8729336003 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jayhawk Primary Care IncGroup PAC ID 8123928900, 157 clinicians

Practice addresses (Care Compare)

20333 W 151St St
Olathe, KS 66061-5350
Phone (913) 588-1227

20805 W 151St St
Suite 224
Olathe, KS 66061-7249
Phone (913) 588-1227

7405 Renner Rd
Shawnee, KS 66217-9414
Phone (913) 588-8400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jayhawk Primary Care Inc Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients
Jayhawk Primary Care Inc Internal Medicine Current Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince May 2, 2023 Accepting new patients
Olathe Medical Center Inc Past Accepting new patients
Jayhawk Primary Care Inc Past Accepting new patients

Locations

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

20333 W 151st St
Olathe, KS 66061
Phone (888) 960-1393

20805 W 151st St
Ste 224
Olathe, KS 66061
Phone (913) 355-8400

23450 College Blvd
Olathe, KS 66061
Phone (913) 355-7788

7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9997a5fc-aad4-42a6-b005-45276937bbd0/

Organizations & group practices 6

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.

Hospital & facility affiliations 12

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": "1528588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1891288338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20805 W 151ST ST STE 224",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617249",
            "telephone_number": "913-355-8400",
            "fax_number": "913-782-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20805 W 151ST ST STE 224",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617249",
            "telephone_number": "913-355-8400",
            "fax_number": "913-782-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMIS",
        "first_name": "FADDY",
        "middle_name": "IMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-10",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-45075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FADDY",
            "last_name": "KHAMIS",
            "middle_name": "IMAD",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.