Individual provider Active NPI

Reda Mohamad Chalhoub

  • Student in an Organized Health Care Education/Training Program
  • Atlanta, GA
National Provider Identifier
1174360572
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
17323 Issued in GA
Practice address
1365 Clifton Rd NE Ste B6200
Atlanta, GA 30322-1013
Phone
(843) 345-6889
NPI assigned
Jul 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 17323 GA Primary

Addresses

Primary practice location

1365 Clifton Rd NE Ste B6200
Atlanta, GA 30322-1013

Mailing address

1365 Clifton Rd NE Ste B6200
Atlanta, GA 30322-1013
Phone (843) 345-6889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250514002212 GA Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 5799203667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17323GAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1174360572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE STE B6200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "843-345-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE STE B6200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "843-345-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALHOUB",
        "first_name": "REDA",
        "middle_name": "MOHAMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "17323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.