Khadija Khan, M.B.,B.S.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1601 W 40TH Ave Ste 100
Pine Bluff, AR 71603-6069

Phone

(870) 541-6000

Fax

(870) 541-6009

NPI assigned

Mar 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Practice Associates of Clarksville,PA

  • Legal Medicine
  • Clarksville, AR
  • NPI 1518957240
  NPD (past)

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1902546575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 W 40TH AVE STE 100",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036069",
            "telephone_number": "870-541-6000",
            "fax_number": "870-541-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W 40TH AVE STE 100",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036069",
            "telephone_number": "870-541-6000",
            "fax_number": "870-541-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KHADIJA",
        "credential": "M.B.,B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Antoinette Kent, M.D.
• Kforney
• Abrar Khan, MD
• Aneeka Khan, MD
• Ghulam Khan, MD
• Chiquita King
• Deanne L. King, MD
• Jasmine King, LPN
• Leslie King, M.S. SLP
• Shatera Cambire King, BS

• Student in an Organized Health Care Education/Training Program in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Student in an Organized Health Care Education/Training Program in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.