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FAREESA KHAN LLC
NPI 1780923490
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Saint Louis, MO

Active since February 01, 2013
10004 KENNERLY RD STE 255A, SAINT LOUIS, MO 63128(314) 270-9880 Get Directions Write a Review

NPPES record last updated: July 10, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 10, 2020, Dec 5, 2018, Mar 27, 2018 (3 updates tracked since 2018).

About Fareesa Khan Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAREESA KHAN LLC (NPI 1780923490) is a healthcare organization registered as an urogynecology and reconstructive pelvic surgery in Saint Louis, Missouri and active in the NPI registry since February 2013. The organization lists Fareesa G Khan, Owner, as its authorized official.

NPPES Registry Identity

NPI1780923490
Entity TypeOrganization
Primary Taxonomy207VF0040X
Legal Business NameFAREESA KHAN LLC
Location Address10004 KENNERLY RD STE 255ASaint Louis, MO 63128-2184
Mailing AddressPo Box 410085Saint Louis, MO 63141-0085 · (636) 675-3107
Phone(314) 270-9880
Organization SubpartNo
Authorized OfficialFareesa G KhanOwner · (636) 675-3107
Enumeration DateFebruary 1, 2013
Last NPPES UpdateJuly 10, 20203 updates tracked since enumeration
NPPES CertifiedJuly 10, 2020
✔ NPI 1780923490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Urogynecology and Reconstructive Pelvic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207VF0040X
License✔ Licensed in MO · 112917
Definition
A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.
10004 KENNERLY RD STE 255A, Saint Louis, MO 63128
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Other Identifiers 1

Medicaid203820014MO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Fareesa Khan LLC's NPI number?

The NPI number for Fareesa Khan LLC is 1780923490. It was assigned to this organization in the NPPES registry on February 1, 2013.

Where is Fareesa Khan LLC located?

Fareesa Khan LLC is located at 10004 Kennerly Rd Ste 255A, Saint Louis, MO 63128. The listed phone number is (314) 270-9880.

What is Fareesa Khan LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 207VF0040X.

When was this NPI record last updated?

The NPPES record for Fareesa Khan LLC was last updated on July 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.