SIDDIQA K KHAN (NPI# 1740289180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740289180 |
| Entity Type | Individual |
| Full Name | SIDDIQA K KHAN |
| Credential | MD |
| Practice Address |
1833 Boulevard Va Outpatient Clinic Jacksonville FL 32206-4382 |
| Mailing Address |
1833 Boulevard Jaclsonville Va Outpatient Clinic Jacksonville FL 32206-4382 |
| Practice Telephone | 9042322751 |
| Practice Fax Number | 9043012502 |
| Mailing Telephone | 9042322751 |
| Mailing Fax Number | 9043012502 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2011-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 90990 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AV MED | 298827 | 01 |
| FL | CIGNA | 3164176 | 01 |
| FL | 2785404-00 | 05 | |
| FL | HEALTHEASE | 392117 | 01 |
| FL | FIRST COAST ADVANTAGE | 2064269 | 01 |
| Street Address |
1833 BOULEVARD VA OUTPATIENT CLINIC |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32206-4382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306322656 | Johnnie Bradley-goodman | Nurse Practitioner | 1833 Boulevard, Jacksonville, FL 32206 | 2018-07-18 |
| 1538541321 | Daniel Kwamena Korsah | Nurse Practitioner | 1833 Boulevard, 5th Floor, Jacksonville, FL 32206-4382 | 2015-06-29 |
| 1902296080 | Byron Melvin Johnson | Nurse Practitioner | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2015-01-28 |
| 1932448321 | Martha Michelle Hicks | Nurse Practitioner | 1833 Boulevard, Ufjp - Chfm - Shands Total Care Clinic, Jacksonville, FL 32206-4382 | 2013-02-06 |
| 1447524012 | Tracie Claudice Rutledge | Nurse Practitioner | 1833 Boulevard, Ufjax - Total Care Clinic, Jacksonville, FL 32206-4382 | 2012-02-29 |
| 1649543232 | Monica Lynn Monahan | Psychologist | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2012-02-14 |
| 1932436169 | Lionel Staplefoote | Case Manager/Care Coordinator | 1833 Boulevard, Suite 500, Jacksonville, FL 32206-4382 | 2009-11-09 |
| 1770810251 | Christina Adkins Shotwell | Psychologist | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2009-11-04 |
| 1245564327 | Maria Antoun | Pharmacist | 1833 Boulevard, Jacksonville, FL 32206-4382 | 2009-09-23 |
| 1932330016 | Denise A Daniels | Counselor | 1833 Boulevard, Suite 500, Jacksonville, FL 32206-4382 | 2009-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790275543 | Marvin Victor Sindel IIi | Nurse Practitioner | 1241 E 8th St, Jacksonville, FL 32206 | 2018-05-17 |
| 1982126553 | Marcia Camille Holloway | In Home Supportive Care | 647 East 31th Street, Jacksonville, FL 32206 | 2017-07-14 |
| 1407302656 | Tahnita Fleming | Day Training, Developmentally Disabled Services | 1309 Van Buren Street, Jacksonville, FL 32206 | 2016-08-28 |
| 1912202136 | Bishop Home Care, Inc | Clinic/Center | 1627 E 8th Street, Jacksonville, FL 32206 | 2011-01-19 |
| 1407183965 | Richard Adam Crosby | Chiropractor | 4211 North Pearl St., Jacksonville, FL 32206 | 2009-11-04 |
| 1346494903 | Delvenia Renee Mitchell | Specialist | 4515 N Pearl St Apt 2, Jacksonville, FL 32206 | 2008-11-10 |
| 1962662775 | Curtis Michael Bryant | Radiology | 2015 Jefferson Street, University of Florida Proton Institute, Jacksonville, FL 32206 | 2008-06-15 |
| 1932253879 | Gale Marie Cohen-weiss | Social Worker | Veterans Health System, Jacksonville Outpatient Clinic, 1833 Boulevard, Jacksonville, FL 32206 | 2007-01-22 |
| 1396817557 | Bella Caimol Ejercito | Internal Medicine | 4608 Norwood Ave, Jacksonville, FL 32206 | 2006-11-14 |
| 1962584433 | Jessica Ivette Warthen | Pharmacist | 1833 Boluevard, Department of Veterans Affairs; Mental Health Clinic, Jacksonville, FL 32206 | 2006-10-20 |
| Find all providers in zip 32206 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676186 | Sarah Colleen Tapscott | Family Medicine | 1908 Mill Creek Rd, Jacksonville, FL 32211-5052 | 2020-07-20 |
| 1790303170 | Samantha L Scott | Family Medicine | 516 Pierce Ln, Jacksonville, TX 75766-4546 | 2020-07-11 |
| 1689298689 | Meridian Spine and Joint, Inc | Family Medicine | 9770 Old Baymeadows Rd Ste 139, Jacksonville, FL 32256-7986 | 2020-06-04 |
| 1154942563 | Families First Medical Group | Family Medicine | 12086 Fort Caroline Rd Ste 103, Jacksonville, FL 32225-2688 | 2020-04-27 |
| 1598396392 | Pareto Population Health Management Practice Pllc | Family Medicine | 1697 Kings Rd Ste 1, Jacksonville, FL 32209-6169 | 2020-01-30 |
| 1942862206 | Cindy S Wright Do Pllc | Family Medicine | 12627 San Jose Blvd Ste 902, Jacksonville, FL 32223-8645 | 2019-07-07 |
| 1942868377 | Pain Spine & Wellness LLC | Family Medicine | 9770 Old Baymeadows Rd Ste 141, Jacksonville, FL 32256-7986 | 2019-05-31 |
| 1669035705 | Kathy Jo Daniels | Family Medicine | 10457 Wellington Springs Way, Jacksonville, FL 32221-1175 | 2019-04-15 |
| 1821579103 | Tiffany N Major | Family Medicine | 5194 Johnson Creek Dr, Jacksonville, FL 32218-9308 | 2018-08-24 |
| 1568987360 | Main Street Health LLC | Family Medicine | 2 Shircliff Way Ste 620, Jacksonville, FL 32204-4762 | 2017-08-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32206 |
Please comment or provide details below to improve the information on SIDDIQA K KHAN.
| 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.