Individual provider Active NPI

Kathleen Sullivan Khan, M.D.

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
National Provider Identifier
1043536394
Registry record updated Aug 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
71890 Issued in GA
Practice address
275 Collier Rd NW
Suite 100-B
Atlanta, GA 30309-1709
Phone
(404) 352-3656
NPI assigned
Apr 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4612 GA
Obstetrics & Gynecology Physician 207V00000X 71890 GA Primary

Addresses

Primary practice location

275 Collier Rd NW
Suite 100-B
Atlanta, GA 30309-1709

Mailing address

275 Collier Rd NW
Atlanta, GA 30309-1709

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
I20141030001837 GA Practitioner - Obstetrics/Gynecology 8426279720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Emory University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Women'S Heathcare Specialists, LLCGroup PAC ID 0345246021, 46 clinicians

Practice addresses (Care Compare)

275 Collier NWRD
Atlanta, GA 30309-1700

275 Collier Rd NW
Suite 270
Atlanta, GA 30309-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4612GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Women'S Heathcare Specialists, LLC Obstetrics & Gynecology CurrentSince Aug 4, 2014 Accepting new patients
Atlanta Women'S Healthcare Specialists 3 LLC Obstetrics & Gynecology Past Accepting new patients

Locations

275 Collier Rd NW
Ste 100B
Atlanta, GA 30309
Phone (404) 352-1235

275 Collier Rd NW
Ste 100A
Atlanta, GA 30309
Phone (404) 352-1235

Organizations & group practices 2

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": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406937600000",
    "number": "1043536394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW",
            "address_2": "SUITE 100-B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091709",
            "telephone_number": "404-352-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KATHLEEN",
        "middle_name": "SULLIVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2014-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "4612",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "71890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.