Organization Active NPI

George Khachan, M.D., P.a.

  • Obstetrics & Gynecology Physician
  • Cumberland, MD
National Provider Identifier
1902162530
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D38971 Issued in MD
Legal business name
GEORGE KHACHAN, M.D., P.A.
Practice address
625 Kent Ave
Suite 301
Cumberland, MD 21502-3794
Phone
(301) 724-1151
Fax
(301) 724-1894
NPI assigned
Apr 9, 2012
Last updated
Apr 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Authorized official

Name
Mrs. Debbie Gordon
Title
Office Manager
Phone
(301) 724-1151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D38971 MD Primary

Addresses

Primary practice location

625 Kent Ave
Suite 301
Cumberland, MD 21502-3794

Mailing address

625 Kent Ave
Suite 301
Cumberland, MD 21502-3794
Phone (301) 724-1151

Other identifiers 1

IdentifierTypeStateIssuer
069751600MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120501000256 MD Part B Supplier - Clinic/Group Practice 7618139080 Receives reassigned benefits from 1 practitioner
Practice locations: Cumberland, MD

National Provider Directory

National Provider Directory

Locations

625 Kent Ave
Ste 301
Cumberland, MD 21502
Phone (301) 724-1151

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1902162530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENT AVE",
            "address_2": "SUITE 301",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215023794",
            "telephone_number": "301-724-1151",
            "fax_number": "301-724-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENT AVE",
            "address_2": "SUITE 301",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215023794",
            "telephone_number": "301-724-1151",
            "fax_number": "301-724-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE KHACHAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-724-1151",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D38971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069751600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.