Active NPI
Nashat M Khanfar, M.D.
- Pediatrics Physician
- Monroe, LA
National Provider Identifier
1992704142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 13306R
- Practice address
- 3116 Kilpatrick Blvd
Monroe, LA 71201 - Phone
- (318) 410-9898
- Fax
- (318) 807-9002
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 13306R | LA | Primary |
Addresses
Primary practice location
3116 Kilpatrick Blvd
Monroe, LA 71201
Mailing address
130 Desiard St
Ste 355
Monroe, LA 71201-7319
Phone (318) 807-7875
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1559067 | Medicaid | LA |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13306R | LA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1992704142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 DESIARD ST",
"address_2": "STE 355",
"city": "MONROE",
"state": "LA",
"postal_code": "712017319",
"telephone_number": "318-807-7875",
"fax_number": "318-812-9997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3116 KILPATRICK BLVD",
"city": "MONROE",
"state": "LA",
"postal_code": "71201",
"telephone_number": "318-410-9898",
"fax_number": "318-807-9002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHANFAR",
"first_name": "NASHAT",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "13306R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1559067",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.