Shan Khan, D.O.

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

25198 Issued in MS

Practice address

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Phone

(901) 226-2800

Fax

(901) 226-2802

NPI assigned

Apr 11, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Hospice/Palliative Care

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Trinity Home Care and Hospice Hospice, Cordova, TN, CCN 441536
• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141

Merit-based Incentive Payment System (MIPS)

Final score

81.87 of 100Reported as group

Quality

64.75

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  MS

  Medicare reassignment Care Compare group NPD
• Memphis Muslim Medical Services Inc

  • Family Medicine Physician
  • Memphis, TN
  • NPI 1710860192
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation
• LHCG XCV, LLC

  • Community Based Hospice Care Agency
  • Cordova, TN
  • NPI 1659807865
  Care Compare affiliation

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

{
    "created_epoch": "1428710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1972999423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 LIGHTHOUSE LN",
            "city": "LAKELAND",
            "state": "TN",
            "postal_code": "380028159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "901-226-2800",
            "fax_number": "901-226-2802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Alcorn Dr",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "MS",
            "postal_code": "388349321",
            "country_code": "US",
            "telephone_number": "662-293-7686",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "49 N Dunlap St",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032802",
            "country_code": "US",
            "telephone_number": "901-287-5584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "956 Court Ave Suite H314",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381639321",
            "country_code": "US",
            "telephone_number": "901-448-2510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 Stratford Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381222920",
            "country_code": "US",
            "telephone_number": "901-685-3901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6027 Walnut Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202145",
            "country_code": "US",
            "telephone_number": "901-226-2800",
            "fax_number": "901-226-2802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-11",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "25198",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "DO0000003262",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "TN",
            "license": "DO0000003262",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "25198",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "DO0000003262",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MS",
            "license": "25198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Lee Kennedy, P.T.
• Key Therapy, PLLC
• Taylor Nicole Keys, O.D.
• Fazila Khaliq, MD
• Nabeel Hasan Khan, M.D.
• Caroline Kidder
• Marcia W Kidder, P.T.
• Kidney Disease Consultants, P.C.
• Kimberly Rachelle Kilpatrick, RD, LD
• Nikara Kilpatrick, P.A.

• Hospice and Palliative Medicine (Internal Medicine) Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.