ATIYA S. KHAN (NPI# 1881691368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881691368 |
| Entity Type | Individual |
| Full Name | ATIYA S. KHAN |
| Credential | M.D. |
| Practice Address |
11104 Parkview Circle Dr Ste 110 Fort Wayne IN 46845-1673 |
| Mailing Address |
3926 New Vision Dr Bldg H Fort Wayne IN 46845-1712 |
| Practice Telephone | 2604603100 |
| Practice Fax Number | 2604603130 |
| Mailing Telephone | 2602668213 |
| Mailing Fax Number | 2604585658 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2016-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
01059831A | IN | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
01059831A | IN | Allopathic & Osteopathic Physicians |
| N | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
01059831A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4851469 | 05 | |
| IN | 200507010 | 05 | |
| OH | 2168078 | 05 | |
| IN | RR MEDICARE | P00200805 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538213384 | Atiya Batool Khan | Pediatrics | 14333 Laurel Bowie Road, Suite 303, Laurel, MD 20708 | 2007-01-22 |
| Street Address |
11104 PARKVIEW CIRCLE DR STE 110 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780681254 | Frances R. Goff | Clinical Neuropsychologist | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1730 | 2005-06-30 |
| 1164938007 | Brandon Emry | Registered Nurse | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1673 | 2017-12-14 |
| 1750892675 | Curtis Lake | Physician Assistant | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1673 | 2017-10-18 |
| 1033651260 | Caitlin Camp | Registered Nurse | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845 | 2016-11-04 |
| 1093102022 | Leah Dickstein | Psychiatry & Neurology | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1673 | 2015-04-16 |
| 1699196519 | Erin Miles | Clinical Neuropsychologist | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1673 | 2013-12-19 |
| 1164860052 | Jacob Thomas Lutz | Clinical Neuropsychologist | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1673 | 2013-06-13 |
| 1467728378 | Usman Kareem Qadeer | Psychiatry & Neurology | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1673 | 2012-03-25 |
| 1275806663 | Vivian L Appiarius | Nurse Practitioner | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845-1673 | 2012-02-15 |
| 1225321664 | Stephanie Reed Falatko | Neurological Surgery | 11104 Parkview Circle Dr Ste 110, Fort Wayne, IN 46845 | 2011-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871668582 | Indiana Epilepsy and Child Neurology, Inc. | Psychiatry & Neurology | 4310 Lake Ave, Fort Wayne, IN 46815-7222 | 2006-11-21 |
| 1851357586 | Ahmad B Al-hamda | Psychiatry & Neurology | 7956 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104032614 | Jennifer Ann Zimmer | Psychiatry & Neurology | 575 West Dr, Xe 040, Indianapolis, IN 46202-5272 | 2007-05-14 |
| 1790802064 | Lisa M Mcguire | Psychiatry & Neurology | 8414 Naab Rd Ste 205, Indianapolis, IN 46260-1972 | 2007-03-23 |
| 1285716407 | Amy Suzon Chappell | Psychiatry & Neurology | 8111 Bayberry Ct, Indianapolis, IN 46250-1629 | 2006-10-19 |
| 1922190859 | Daksha C Vyas | Psychiatry & Neurology | 200 E. 89th Ave., Suite 3 - B, Merrillville, IN 46410-7319 | 2006-09-28 |
| 1497858518 | Robert Milford Shuman | Psychiatry & Neurology | 50688 Lilac Rd, South Bend, IN 46628-9387 | 2006-09-06 |
| 1902860059 | Elizabeth Hong Magno | Psychiatry & Neurology | 8315 Virginia St, Suite M, Merrillville, IN 46410-6238 | 2006-04-14 |
| 1265708333 | Lauren Bader James | Psychiatry & Neurology | 8414 Naab Rd, Indianapolis, IN 46260-1972 | 2012-03-22 |
| 1881824795 | Kelly Marie Kremer | Psychiatry & Neurology | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2009-07-27 |
| 1538327283 | Andrew Michael Miller | Psychiatry & Neurology | 13100 E 136th St, Ste 1200, Fishers, IN 46037-9418 | 2008-05-29 |
| 1295933349 | Kofi Dela Quist | Psychiatry & Neurology | 8051 S Emerson Ave Ste 350, Indianapolis, IN 46237-8634 | 2007-07-10 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
Please comment or provide details below to improve the information on ATIYA S. 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.