Individual provider Active NPI

Shameela Nasrullah Khimani, MD

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1013545854
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125.076214 Issued in IL
Practice address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 617-3239
NPI assigned
Mar 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 125.076214 IL Primary

Addresses

Primary practice location

1201 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-3239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250830000250 GA Practitioner - Allergy/Immunology 3072973858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Allergy and Asthma Clinic PAGroup PAC ID 1254372006, 42 clinicians

Practice addresses (Care Compare)

2045 Peachtree Rd NE
Suite 800
Atlanta, GA 30309-1407
Phone (404) 351-5711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.076214ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Allergy & Asthma Clinic PA CurrentSince Jul 1, 2025 Accepting new patients

Locations

2045 Peachtree Rd NE
Ste 800
Atlanta, GA 30309
Phone (404) 351-5711

100 Old Ball Ground Hwy
#B
Canton, GA 30114
Phone (770) 720-8000

114 Townpark Dr NW
Ste 240
Kennesaw, GA 30144
Phone (770) 485-3723

790 Church St NE
Ste 150
Marietta, GA 30060
Phone (770) 422-4268

1357 Hembree Rd
Ste 200
Roswell, GA 30076
Phone (770) 475-0807

1600 Medical Way
Ste 200
Snellville, GA 30078
Phone (770) 979-7466

4025 Johns Creek Pkwy
Ste 300
Suwanee, GA 30024
Phone (770) 495-6258

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJBFBA

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1013545854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-617-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-617-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHIMANI",
        "first_name": "SHAMEELA",
        "middle_name": "NASRULLAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.076214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.