DASTAGIR A KHAN MD, PA (NPI# 1073815676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073815676 |
| Entity Type | Organization |
| Organization Name | DASTAGIR A KHAN MD, PA |
| Practice Address |
800 Prudential Dr Jacksonville FL 32207-8202 |
| Mailing Address |
207 Barony Dr Jacksonville FL 32225-6119 |
| Practice Telephone | 9049557190 |
| Mailing Telephone | 9049557190 |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |
| Authorized Official Name | DR. DASTAGIR KHAN (PHYSICIAN) |
| Authorized Official Telephone | 9049557190 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | ARNP9264398 | FL | Hospitals |
| Street Address |
800 PRUDENTIAL DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013913854 | Annette Davidson Bell | Family Medicine | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2005-06-27 |
| 1508467523 | Heather Smith | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-11-05 |
| 1306446638 | Jessica Schilz | Dietitian, Registered | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-10-27 |
| 1033718747 | Kiara Michelle Simmons | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-10-22 |
| 1477151488 | Nicole Schumaker | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-10-12 |
| 1609482868 | Anna D Denson | Nurse Practitioner | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-09-22 |
| 1578179453 | Emily Guan Duani | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-09-16 |
| 1487264636 | Heidi Marie Rebholz | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-08-03 |
| 1326657982 | Everrenz Health, Inc | Family Medicine | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-07-29 |
| 1760090302 | Matthew Ryan Jones | Anesthesiologist Assistant | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528683257 | Gainesville Vamc | General Acute Care Hospital | 2080 Child St Bldg 200h, Jacksonville, FL 32214-5005 | 2020-06-09 |
| 1922487974 | Shemaka James | General Acute Care Hospital | 5202 Wabash Blvd, Jacksonville, FL 32254-1366 | 2015-05-22 |
| 1962893149 | Michelle Porter | General Acute Care Hospital | 402 Stagecoach Dr, Jacksonville, NC 28546-8663 | 2015-02-10 |
| 1811246390 | St. Vincent's Healthcare | General Acute Care Hospital | 3 Shircliff Way Ste 714, Jacksonville, FL 32204-4786 | 2012-08-30 |
| 1255570974 | Svila Skin Solutions | General Acute Care Hospital | 1936 San Marco Blvd, Jacksonville, FL 32207-3286 | 2009-02-19 |
| 1760644009 | Walter Ruday Jr. | General Acute Care Hospital | 2748 University Blvd W, Jacksonville, FL 32217-2123 | 2008-06-27 |
| 1386801116 | Abdolreza Mohammadian | General Acute Care Hospital | 1536 N.jefferson Street, Va Outpatient Clinic, Jacksonville, FL 32209-0000 | 2008-05-20 |
| 1861451114 | Allegiance Hospital of North Little Rock, LLC | General Acute Care Hospital | 1400 Braden St., Jacksonville, AR 72076 | 2006-03-23 |
| 1730697350 | Jacksonville Hospital LLC | General Acute Care Hospital | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2018-01-17 |
| 1144735069 | Brynn Marr Hospital - Navy Resource Sharing | General Acute Care Hospital | 192 Village Dr, Jacksonville, NC 28546-7238 | 2017-12-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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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.