Active NPI
Rajan S Kohli MD PA
- Family Medicine Physician
- Dallas, TX
National Provider Identifier
1992288997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- RAJAN S KOHLI MD PA
- Practice address
- 9330 Poppy Dr Ste 503
Dallas, TX 75218-4696 - Phone
- (214) 810-4331
- Fax
- (214) 321-3469
- NPI assigned
- Sep 14, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Rajan S Kohli, MD
- Title
- Owner
- Phone
- (214) 810-4331
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
9330 Poppy Dr Ste 503
Dallas, TX 75218-4696
Mailing address
5606 Winton St
Dallas, TX 75206-5354
Phone (903) 806-5892
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181128000175 | TX | Part B Supplier - Clinic/Group Practice | 8224372578 |
Receives reassigned benefits from 3 practitioners Practice locations: Dallas, TX |
National Provider Directory
National Provider DirectoryLocations
9330 Poppy Dr
Ste 308
Dallas, TX 75218
Phone (214) 810-4331
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598486400000",
"number": "1992288997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5606 WINTON ST",
"city": "DALLAS",
"state": "TX",
"postal_code": "752065354",
"telephone_number": "903-806-5892",
"fax_number": "469-248-0653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9330 POPPY DR STE 503",
"city": "DALLAS",
"state": "TX",
"postal_code": "752184696",
"telephone_number": "214-810-4331",
"fax_number": "214-321-3469"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RAJAN S KOHLI MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2018-09-14",
"last_updated": "2020-08-27",
"certification_date": "2020-08-26",
"status": "A",
"authorized_official_last_name": "KOHLI",
"authorized_official_first_name": "RAJAN",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "214-810-4331",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.