Shazia Khan, MD
Individual provider Active NPI Nephrology Physician · Newnan, GA
NPI 1164526323 · NPPES record last updated Oct 31, 2022
Key facts
- NPI
- 1164526323
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 048905 (GA)
- Practice address
- 1425 Highway 34 E
Newnan, GA 30265-1323 - Phone
- (770) 304-3724
- Fax
- (770) 304-3726
- NPI assigned
- Sep 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Nephrology, Inc.
City of Hope Medical Group of Georgia LLC
Practice addresses (Care Compare)
1425 E Hwy 34
Newnan, GA 30265-1323
Phone (770) 304-3724
1425 Hwy 34 E
Newnan, GA 30265-1323
600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone (770) 400-6080
Hospital & facility affiliations
- FMC - Newnan Dialysis Services
- FMC - Rai - Hwy - Fayetteville
- FMC - Palmetto Dialysis Clinic
- Satellite Wellbound of Newnan, LLC
- DaVita Poplar Dialysis
- Piedmont Newnan Hospital, Inc
- Piedmont Fayette Hospital
- Southeastern Regional Medical Center, Inc
- Piedmont Henry Hospital
- Rehabilitation Hospital of Newnan
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.62 of 100
- Quality
- 83.25
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.74 of 100
- Quality
- 63.81
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 57.71
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110118001031 | GA | Practitioner - Nephrology |
7214029883 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048905 | GA | MD | Nephrology Physician |
| 19313 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Hope Medical Group of Georgia LLC | Current |
Accepting new patients | |
| Coastal Kidney Center PA | Nephrology | Past |
Accepting new patients |
| Waccamaw Dermatology, LLC | Past |
Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334
62742 Collections Ctr Dr
Chicago, IL 60693
Interoperability endpoints
- skhan166860@cityofhope.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 048905 | GA | Yes |
Addresses
Primary practice location
1425 Highway 34 E
Newnan, GA 30265-1323
Mailing address
1425 Highway 34 E
Newnan, GA 30265-1323
Phone (770) 304-3724
Other practice location 1
130 Governors Sq Ste C
Peachtree City, GA 30269-4862
Phone (770) 376-6256
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GRP4757 | Other | GA | MEDICARE GROUP NUMBER |
| 39BDCFQ | Other | GA | CARRIER PROVIDER NUMBER |
Other providers in Newnan, GA
- Ryan Mathew Kervin
- Chad M. Kessler
- Reinhard Ketsche
- Keystone Chiropractic Associates of Newnan, LLC
- Mishal Shoaib Khan
- Syeda Maimuna Ali Khan
- Geeta Bai Khanwani
- Michael Nabil Khoury
- Amanda Kidder
- Kidney Nutrition Specialist LLC
All providers in Newnan, GA · Nephrology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.