Individual provider Active NPI

Ahmed Khan, M.D.

  • Internal Medicine Physician
  • Durham, NC
National Provider Identifier
1043470750
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
082320 Issued in GA
Practice address
Department of Internal Medicine
Duke University Medical Center
Durham, NC 27710-0001
Phone
(919) 740-5882
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 150024 NC
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 082320 GA Primary

Addresses

Primary practice location

Department of Internal Medicine
Duke University Medical Center
Durham, NC 27710-0001

Mailing address

3495 Piedmont Rd NE BLDG 9 3Rd Floor
Attn Tobie Shelley
Atlanta, GA 30305-1736
Phone (404) 365-0966

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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
I20190614001867 GA Practitioner - Internal Medicine 5496925885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

550 Peachtree St NE
Atlanta, GA 30308-2212
Phone (404) 364-7285

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
082320GAMDInternal Medicine Physician
150024NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Multi-Specialty CurrentSince May 6, 2019 Accepting new patients
Rex Hospital Inc Multi-Specialty Past Accepting new patients
Rex Hospital, Inc. Multi-Specialty Past Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1043470750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE BLDG 9 3RD FLOOR",
            "address_2": "ATTN TOBIE SHELLEY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051736",
            "telephone_number": "404-365-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF INTERNAL MEDICINE",
            "address_2": "DUKE UNIVERSITY MEDICAL CENTER",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-740-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AHMED",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "150024",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "082320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "550 West Peachtree Street, NW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303082247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.