SHALOM MENTAL HEALTH SERVICES
NPI 1154179778
Clinic/Center - Mental Health (Including Community Mental Health Center) in Anoka, MN
About Shalom Mental Health Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHALOM MENTAL HEALTH SERVICES (NPI 1154179778) is a healthcare organization registered as a mental health (including community mental health center) in Anoka, Minnesota and active in the NPI registry since May 2024. The organization lists Azie Judith Khan, Owner/ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shalom Mental Health Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Shalom Mental Health Services, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shalom Mental Health Services's NPI number?
The NPI number for Shalom Mental Health Services is 1154179778. It was assigned to this organization in the NPPES registry on May 8, 2024.
Where is Shalom Mental Health Services located?
Shalom Mental Health Services is located at 3751 Ridge Ave, Anoka, MN 55303. The listed phone number is (515) 918-3955.
What is Shalom Mental Health Services's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Shalom Mental Health Services enrolled in Medicare?
Yes. Shalom Mental Health Services is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shalom Mental Health Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Shalom Mental Health Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Shalom Mental Health Services was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shalom Mental Health Services · NPI 1154179778
Mental Health (Including Community Mental Health Center) organization in Anoka, Minnesota. Organization record, active in the CMS NPPES registry since May 8, 2024.
## Identity
- **NPI:** 1154179778 (Entity type: Organization)
- **Enumerated:** May 8, 2024
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Also known as:** SHALOM MENTAL HEALTH SERVICES (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Azie Khan, OWNER/CEO
## Practice location
- **Address:** 3751 RIDGE AVE, Anoka, MN 55303-1489
- **Phone:** (515) 918-3955
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 8, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1154179778) · Data from the CMS NPPES public registry.