Active NPI
Shawan Mehdi Khan, PHARM. D.
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1982258836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302045241
- Practice address
- 800 Leonard St NW
Grand Rapids, MI 49504-4148 - Phone
- (616) 458-8300
- NPI assigned
- Jul 30, 2019
- Last updated
- Feb 23, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302045241 | MI | Primary |
Addresses
Primary practice location
800 Leonard St NW
Grand Rapids, MI 49504-4148
Mailing address
2772 Tittabawassee Rd
Saginaw, MI 48604-9433
Phone (989) 793-5701
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302045241 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582416000000",
"number": "1982258836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2772 TITTABAWASSEE RD",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486049433",
"telephone_number": "989-793-5701",
"fax_number": "989-484-9263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 LEONARD ST NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495044148",
"telephone_number": "616-458-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "SHAWAN",
"middle_name": "MEHDI",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-30",
"last_updated": "2020-02-23",
"certification_date": "2020-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302045241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.