NPIMap

Organization Active NPI

A.M. Faheem, M.D., P.S.C.

  • Specialist
  • Elizabethtown, KY
National Provider Identifier
1932266947
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
A.M. FAHEEM, M.D., P.S.C.
Practice address
914 N Dixie Ave
Suite 302
Elizabethtown, KY 42701-2520
Phone
(270) 769-0892
Fax
(270) 769-1857
NPI assigned
Jan 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Amjad M Faheem, MD
Title
President
Phone
(270) 769-0892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

914 N Dixie Ave
Suite 302
Elizabethtown, KY 42701-2520

Mailing address

914 N Dixie Ave
Suite 302
Elizabethtown, KY 42701-2520
Phone (270) 769-0892

Other identifiers 6

IdentifierTypeStateIssuer
1055519OtherKYELIZABETHTOWN OFFICE PP#
1055553OtherKYRADCLIFF PASSPORT #
1055554OtherKYHODGENVILLE OFFICE PASS#
65937468MedicaidKY
65937476MedicaidKY
65937492MedicaidKY

National Provider Directory

National Provider Directory

Locations

914 N Dixie Ave
Ste 302
Elizabethtown, KY 42701
Phone (270) 706-1943

Practitioners & affiliated clinicians

Practitioners 11

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932266947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "address_2": "SUITE 302",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-769-0892",
            "fax_number": "270-769-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "address_2": "SUITE 302",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-769-0892",
            "fax_number": "270-769-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.M. FAHEEM, M.D., P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAHEEM",
        "authorized_official_first_name": "AMJAD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-769-0892",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELIZABETHTOWN OFFICE PP#",
            "identifier": "1055519",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADCLIFF PASSPORT #",
            "identifier": "1055553",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HODGENVILLE OFFICE PASS#",
            "identifier": "1055554",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65937468",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65937476",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65937492",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.