Individual provider Active NPI

Ibhar Al Mheid, MD

  • Cardiovascular Disease Physician
  • Decatur, GA
National Provider Identifier
1083841670
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
66979 Issued in GA
Practice address
2124 Candler Rd
Decatur, GA 30032-5572
Phone
(404) 836-0272
Fax
(404) 666-0038
NPI assigned
Jun 22, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 66979 GA Primary

Addresses

Primary practice location

2124 Candler Rd
Decatur, GA 30032-5572

Mailing address

2124 Candler Rd
Decatur, GA 30032-5572
Phone (404) 836-0272

Other identifiers 1

IdentifierTypeStateIssuer
66979OtherGAMEDICAL LICENESE

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
I20171114003749 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Hospitalist 8123384799 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66979GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc Cardiovascular Disease CurrentSince May 28, 2020 Accepting new patients
Jencare Neighborhood Medical Center West End, LLC PastSince Aug 4, 2014 Accepting new patients

Locations

1436 Broadrick Dr
Ste B
Dalton, GA 30720
Phone (706) 226-3434

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

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.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083841670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325572",
            "telephone_number": "404-836-0272",
            "fax_number": "404-666-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325572",
            "telephone_number": "404-836-0272",
            "fax_number": "404-666-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL MHEID",
        "first_name": "IBHAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2023-03-07",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "66979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENESE",
            "identifier": "66979",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.