Active NPI
Khalid Jalil Manzar, M.D.
- Interventional Cardiology Physician
- London, KY
National Provider Identifier
1962469452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- MD457745
- Practice address
- 1210 W 5TH St
Ste 100
London, KY 40741-2112 - Phone
- (606) 864-4040
- Fax
- (606) 864-3500
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 34308 | IA | |
| Interventional Cardiology Physician | 207RI0011X | MD457745 | PA | Primary |
Addresses
Primary practice location
1210 W 5TH St
Ste 100
London, KY 40741-2112
Mailing address
PO Box 73652
Cleveland, OH 44193-0002
Phone (859) 313-2758
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IA0193 | Other | JOHN DEERE HEALTH | |
| 0247221 | Medicaid | IA | |
| 67134 | Other | IOWA HEALTH SOLUTIONS | |
| 43330 | Other | WELLMARK BC/BS | |
| 060067839 | Other | RAILROAD MEDICARE | |
| 235475 | Other | MIDLANDS CHOICE | |
| 071725 | Other | HEALTH ALLIANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 98111 | NM | MD | Marriage & Family Therapist |
| 34308 | IA | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461888000000",
"number": "1962469452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 73652",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441930002",
"telephone_number": "859-313-2758",
"fax_number": "859-276-5939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 W 5TH ST",
"address_2": "STE 100",
"city": "LONDON",
"state": "KY",
"postal_code": "407412112",
"telephone_number": "606-864-4040",
"fax_number": "606-864-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZAR",
"first_name": "KHALID",
"middle_name": "JALIL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2016-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IA",
"license": "34308",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "PA",
"license": "MD457745",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH",
"identifier": "IA0193",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0247221",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA HEALTH SOLUTIONS",
"identifier": "67134",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BC/BS",
"identifier": "43330",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "060067839",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "235475",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "071725",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in London, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.