DR. MEHRAN KHAJAVI (NPI# 1013136464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013136464 |
| Entity Type | Individual |
| Full Name | DR. MEHRAN KHAJAVI |
| Credential | M.D. |
| Practice Address |
1004 Sushruta Dr Ste C Martinsburg WV 25401-8801 |
| Mailing Address |
P.o. Box 4458 Leesburg VA 20177 |
| Practice Telephone | 3042640888 |
| Practice Fax Number | 3042640878 |
| Mailing Telephone | 7038952237 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
22758 | WV | Allopathic & Osteopathic Physicians |
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
0101241072 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | MEDICARE PTAN | WV2358C487 | 01 |
| WV | RAILROAD MEDICARE | P00449865 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2011 Professional Court, Martinsburg, WV 25401 | 3042640888 | 3042640878 |
| 601 Potomac Station Dr Ne, Leesburg, VA 201761816 | 7038401396 |
| Street Address |
1004 SUSHRUTA DR STE C |
| City | MARTINSBURG |
| State | WV |
| Zip Code | 25401-8801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912250663 | Family Health Center Pllc | Clinic/Center | 1004 Sushruta Dr Ste C, Martinsburg, WV 25401-8801 | 2012-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020537 | Christina Anne Williams | Nurse Practitioner | 2100 Hospital Drive, Martinsburg, WV 25401 | 2020-07-10 |
| 1013530633 | Pdi Health Wv LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 126 E. Burke Street, Martinsburg, WV 25401 | 2020-05-19 |
| 1699293035 | Tiffany Curry | Social Worker | 653 Winchester Avenue, Martinsburg, WV 25401 | 2017-09-06 |
| 1972042992 | Berkeley County Council | Counselor | 800 Emmett Rousch Drive, Martinsburg, WV 25401 | 2017-02-23 |
| 1023569449 | Heidi Crawford | Registered Nurse | 401 South College Street, Berkeley County Board of Ed, Martinsburg, WV 25401 | 2016-10-20 |
| 1578911293 | Christina Marie Van Hilst | Nurse Practitioner | 1001 Sushruta Dr, Martinsburg, WV 25401 | 2016-06-03 |
| 1578926549 | Barathy Radhakrishnan | Speech-Language Pathologist | 401 Queen Street, Berkeley County Board of Education, Martinsburg, WV 25401 | 2016-03-29 |
| 1972985638 | Wellco Dme LLC | Durable Medical Equipment & Medical Supplies | 107 Tavern Rd, Martinsburg, WV 25401 | 2015-06-18 |
| 1457731960 | Patrick Hamilton Noland | Dentist | 1003 Sushruta Dr., Martinsburg, WV 25401 | 2015-06-01 |
| 1801296330 | Terry Harden | Massage Therapist | 601 South Raliegh St., Martinsburg, WV 25401 | 2014-09-03 |
| Find all providers in zip 25401 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316436694 | Erona Reza | Family Medicine | 6040 University Town Centre Drive, Morgantown, WV 26501-2421 | 2018-05-02 |
| 1063515054 | Melchor F Vidal | Family Medicine | 27545 Daniel Boone Prkwy, Racine, WV 25165 | 2006-09-06 |
| 1629004221 | Collaborative Geriatrics, Inc. | Family Medicine | 414 Mahoganywood Dr, Milton, WV 25541-1181 | 2006-06-24 |
| 1568455442 | Alan L. Barnett | Family Medicine | 933 Cheat Rd, Morgantown, WV 26508-5631 | 2005-08-25 |
| 1548252281 | Vincent Walter Delagarza | Family Medicine | 1 Stadium Drive, Health Sciences Center, Morgantown, WV 26505 | 2005-08-18 |
| 1437426780 | Summersville Family Medicine Inc | Family Medicine | 211 Merchants Walk, Shopping Center, Summersville, WV 26651-1901 | 2011-11-30 |
| 1598979320 | Ambryan L White | Family Medicine | 414 Mahoganywood Dr, Milton, WV 25541-1181 | 2007-05-10 |
| 1821162207 | William Lee Harris | Family Medicine | 3100 Maccorkle Ave Se, Suite 307, Charleston, WV 25304-1223 | 2006-11-20 |
| 1821180530 | William C Mercer | Family Medicine | 58 16th St, 3rd Floor, Wheeling, WV 26003-3660 | 2006-09-29 |
| 1184654832 | Sivaparvati Thagirisa | Family Medicine | One Medical Center Drive, Louis A. Johnson Va Medical Center, Diagnostic Service, Clarksburg, WV 26301 | 2006-07-04 |
| Find all providers with the same taxonomy | ||||
| City | MARTINSBURG |
| Zip Code | 25401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.