NPIMap

Individual provider Active NPI

Iman Sajid Khan, MD

  • Specialist
  • Medford, OR
National Provider Identifier
1952821555
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD208870 Issued in OR
Practice address
760 Golf View Dr Unit 200
Medford, OR 97504-9685
Phone
(541) 618-4400
NPI assigned
Jun 23, 2017
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MD
Specialist 174400000X MD208870 OR Primary

Addresses

Primary practice location

760 Golf View Dr Unit 200
Medford, OR 97504-9685

Mailing address

760 Golf View Dr Unit 200
Medford, OR 97504-9685
Phone (541) 618-4400

Other practice location 1

6565 N Charles St Ste Ppe 203
Towson, MD 21204-6800
Phone (443) 849-2688

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address imankhan@rccpc.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20220721001855 OR Practitioner - Nephrology 9234409624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renal Care Consultants PCGroup PAC ID 9830179134, 13 clinicians

Practice addresses (Care Compare)

760 Golf View Dr
Unit 200
Medford, OR 97504-9685
Phone (541) 618-4400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Care Consultants PC Specialist CurrentSince Aug 1, 2022 Accepting new patients

Locations

760 Golf View Dr
Unit 200
Medford, OR 97504
Phone (541) 618-4400

Interoperability endpoints

  • Direct secure messaging: imankhan@rccpc.allscriptsdirect.net

Organizations & group practices 1

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 9

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1952821555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 GOLF VIEW DR UNIT 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049685",
            "telephone_number": "541-618-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 GOLF VIEW DR UNIT 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049685",
            "telephone_number": "541-618-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 N Charles St Ste Ppe 203",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212046800",
            "country_code": "US",
            "telephone_number": "443-849-2688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "IMAN",
        "middle_name": "SAJID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD208870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imankhan@rccpc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "760 Golf View Dr Unit 200",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975049685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.