Individual provider Active NPI

Khwaja Nmi Hussain, M.D.

  • Family Medicine Physician
  • Goldsboro, NC
National Provider Identifier
1982615746
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9701411 Issued in NC
Practice address
Cherry Hospital
1401 W. Ash Street
Goldsboro, NC 27530-1078
Phone
(919) 947-8237
Fax
(919) 705-5140
NPI assigned
Aug 10, 2006
Last updated
Sep 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9701411 NC Primary

Addresses

Primary practice location

Cherry Hospital
1401 W. Ash Street
Goldsboro, NC 27530-1078

Mailing address

1401 W. Ash Street - Cherry Hospital
Goldsboro, NC 27530-1078
Phone (919) 751-8337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20110121000530 NC Practitioner - Family Practice 7416136544 Practice locations: Goldsboro, NC

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9701411NCMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1982615746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W. ASH STREET - CHERRY HOSPITAL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275301078",
            "telephone_number": "919-751-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHERRY HOSPITAL",
            "address_2": "1401 W. ASH STREET",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275301078",
            "telephone_number": "919-947-8237",
            "fax_number": "919-705-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "KHWAJA",
        "middle_name": "NMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9701411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.