Active NPI
Shama Khan, MD
- Family Medicine Physician
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 110491
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
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
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
- SSM Health at Home Home Health - Oklahoma
- SSM Health St Anthony Hospital - Oklahoma City
- Piedmont Hospital, Inc
- Exceptional Community Hospital Ardmore
- Monroe County Hospital
- O U Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-14524 | AR | MD | Emergency Medicine Physician |
| 110491 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Emergency Staffing Solutions, Inc | Emergency Medicine | Current | Accepting new patients |
| Ess of Fordyce LLC | Emergency Medicine | Current | Accepting new patients |
| Monticello Ess LLC | Emergency Medicine | Current | Accepting new patients |
| Arbuckle Memorial Hospital | Current | Accepting new patients | |
| Hospital Care Consultants of Fordyce LLC | Current | Accepting new patients | |
| HCC of Warren LLC | Current | Accepting new patients | |
| HCC of Warren Hospitalist LLC | Emergency Medicine | Current | Accepting new patients |
| Southeast Arkansas Emergency Physicians LLP | Emergency Medicine | Current | Accepting new patients |
| Saints Medical Group, LLC | Current | Accepting new patients | |
| Exceptional Physicians Group Ardmore Hospital PLLC | Emergency Medicine | Current | Accepting new patients |
| Southeast Arkansas Emergency Physicians LLP | Emergency Medicine | Current | Accepting new patients |
| Saints Medical Group, LLC | Family Medicine | Current | 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.
-
- Emergency Medicine Physician
- Ardmore, OK
- NPI 1588427462
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1437195922
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1912956046
-
- Emergency Medicine Physician
- Elberton, GA
- NPI 1174917124
-
- Critical Access Hospital
- Sulphur, OK
- NPI 1700869492
-
- Emergency Medicine Physician
- Hope, AR
- NPI 1275774630
-
- Emergency Medicine Physician
- Fordyce, AR
- NPI 1821547977
-
- Hospitalist Physician
- Fordyce, AR
- NPI 1316497464
-
- Emergency Medicine Physician
- Monticello, AR
- NPI 1184010753
-
- Emergency Medicine Physician
- Pine Bluff, AR
- NPI 1922475078
-
- Nephrology Physician
- Stockbridge, GA
- NPI 1104088905
-
- Emergency Medicine Physician
- Warren, AR
- NPI 1326641606
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1962461681
-
- Critical Access Hospital
- Forsyth, GA
- NPI 1770684284
-
- Special Hospital
- Ardmore, OK
- NPI 1023754793
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1649794157
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1366545311
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.