Individual provider Active NPI

Imran Khalil, M.D

  • Interventional Cardiology Physician
  • Dothan, AL
National Provider Identifier
1912282948
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD.43540 Issued in AL
Practice address
4300 W Main St Ste 21
Dothan, AL 36305-1058
Phone
(334) 699-7900
Fax
(334) 699-7901
NPI assigned
Oct 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Interventional Cardiology Physician 207RI0011X MD.43540 AL Primary
Interventional Cardiology Physician 207RI0011X 298324 NY
Hospitalist Physician 208M00000X 52814 CT

Addresses

Primary practice location

4300 W Main St Ste 21
Dothan, AL 36305-1058

Mailing address

PO Box 6599
Dothan, AL 36302-6599
Phone (334) 699-7900

Other practice location 1

1481 W 10th St
Indianapolis, IN 46202-2803
Phone (317) 988-4403

Other identifiers 1

IdentifierTypeStateIssuer
43540OtherALLICENSE

Other names 1

  • Imran Alkhalil Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220120000554 AL Practitioner - Interventional Cardiology 6103041645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wiregrass Clinic LLCGroup PAC ID 2860662491, 69 clinicians

Practice addresses (Care Compare)

210 Westside Dr
Dothan, AL 36303-1928
Phone (334) 793-5074

4300 W Main St
Dothan, AL 36305-1058

4370 W Main St
Dothan, AL 36305-1056
Phone (334) 793-4613

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.97 of 100Reported as apm
Quality
75.95
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting124
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.43540ALMDInterventional Cardiology Physician
298324NYMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wiregrass Clinic LLC CurrentSince Apr 10, 2023 Accepting new patients
Cardiology Associates, PA CurrentSince Jan 1, 2022 Accepting new patients
Major Hospital Past Accepting new patients

Locations

4300 W Main St
Ste 102
Dothan, AL 36305
Phone (334) 793-9564

4300 W Main St
Ste 45
Dothan, AL 36305
Phone (334) 673-0049

4300 W Main St
Ste 21
Dothan, AL 36305
Phone (334) 699-7900

1118 Ross Clark Cir
Ste 501
Dothan, AL 36301
Phone (334) 793-9564

Interoperability endpoints

  • Direct secure messaging: imran.khalil.1@3326.direct.athenahealth.com
  • Direct secure messaging: imrankhalil@dothanspcl.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1912282948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6599",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363026599",
            "telephone_number": "334-699-7900",
            "fax_number": "334-699-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST STE 21",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051058",
            "telephone_number": "334-699-7900",
            "fax_number": "334-699-7901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1481 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462022803",
            "country_code": "US",
            "telephone_number": "317-988-4403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "IMRAN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-21",
        "last_updated": "2024-12-03",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AL",
            "license": "MD.43540",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "298324",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "52814",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "43540",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IMRAN",
            "last_name": "ALKHALIL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.