Individual provider Active NPI

Shama Khan, MD

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1083174502
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
110491 Issued in GA
Practice address
105 Collier Rd NW Ste 2000
Atlanta, GA 30309-1734
Phone
(404) 350-1122
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-14524 AR
Emergency Medicine Physician 207P00000X E-14524 AR
Family Medicine Physician 207Q00000X ME155077 FL
Family Medicine Physician 207Q00000X 110491 GA Primary

Addresses

Primary practice location

105 Collier Rd NW Ste 2000
Atlanta, GA 30309-1734

Mailing address

105 Collier Rd NW Ste 2000
Atlanta, GA 30309-1734

Other practice location 1

1601 W 40th Ave Ste 1
Pine Bluff, AR 71603-6319
Phone (870) 541-6000

Other practice location 2

10987 Sheldon Rd Ste 200
Tampa, FL 33626-4702
Phone (813) 467-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210823001198 AR Practitioner - Family Practice 0042615585 Reassigns benefits to 5 organizations
I20230522001392 OK Practitioner - Family Practice 0042615585 Reassigns benefits to 3 organizations
I20260416003990 GA Practitioner - Family Practice 0042615585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians
Exceptional Physicians Group Ardmore Hospital PLLCGroup PAC ID 8921542622, 22 clinicians
Southland Consolidated Emergency Services LLCGroup PAC ID 2860792066, 68 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 2000
Atlanta, GA 30309-1734
Phone (404) 350-1122

13401 N Western Ave
Oklahoma City, OK 73114-1408
Phone (405) 252-3450

1641 Woerz Way
Ardmore, OK 73401-5071
Phone (436) 341-7800

88 Martin Luther King Jr Dr
Forsyth, GA 31029-1682
Phone (478) 994-2521

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-14524ARMDEmergency Medicine Physician
110491GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Emergency Staffing Solutions, Inc Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Ess of Fordyce LLC Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
Monticello Ess LLC Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
Arbuckle Memorial Hospital Current Accepting new patients
Hospital Care Consultants of Fordyce LLC CurrentSince Jun 1, 2022 Accepting new patients
HCC of Warren LLC CurrentSince Jun 1, 2022 Accepting new patients
HCC of Warren Hospitalist LLC Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
Southeast Arkansas Emergency Physicians LLP Emergency Medicine Current Accepting new patients
Saints Medical Group, LLC CurrentSince Jul 1, 2023 Accepting new patients
Exceptional Physicians Group Ardmore Hospital PLLC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Southeast Arkansas Emergency Physicians LLP Emergency Medicine CurrentSince Jul 27, 2021 Accepting new patients
Saints Medical Group, LLC Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients
Ehc Ardmore LLC Past Accepting new patients

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

201 N Clifton St
Fordyce, AR 71742
Phone (870) 352-6300

2729 S Highway 65 82
Lake Village, AR 71653
Phone (870) 265-5351

778 Scogin Dr
Monticello, AR 71655
Phone (870) 367-2411

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

404 S Bradley St
Warren, AR 71671
Phone (870) 226-3731

1641 Woerz Way
Ardmore, OK 73401
Phone (436) 341-7800

13401 N Western Ave
Oklahoma City, OK 73114
Phone (405) 252-3400

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

13401 N Western Ave
Ste 200
Oklahoma City, OK 73114
Phone (405) 252-3450

3514 Cedar Springs Rd
Dallas, TX 75219
Phone (281) 415-6687

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1083174502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COLLIER RD NW STE 2000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COLLIER RD NW STE 2000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091734",
            "telephone_number": "404-350-1122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 W 40th Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716036319",
            "country_code": "US",
            "telephone_number": "870-541-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10987 Sheldon Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336264702",
            "country_code": "US",
            "telephone_number": "813-467-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-14524",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-14524",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME155077",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "110491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.