Active NPI
Roshan N Khaki, R.D.,L.D.,CDE
- Registered Dietitian
- Cumming, GA
National Provider Identifier
1194029678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD002087
- Practice address
- 1505 Northside Blvd
Suite 2800
Cumming, GA 30041-7623 - Phone
- (770) 886-3842
- Fax
- (770) 886-3843
- NPI assigned
- Dec 27, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD002087 | GA | Primary |
Addresses
Primary practice location
1505 Northside Blvd
Suite 2800
Cumming, GA 30041-7623
Mailing address
1505 Northside Blvd
Suite 2800
Cumming, GA 30041-7623
Phone (770) 886-3842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD002087 | GA | MD | Registered Dietitian |
| 2087 | GA | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roshan Khaki, LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1293408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293408000000",
"number": "1194029678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 NORTHSIDE BLVD",
"address_2": "SUITE 2800",
"city": "CUMMING",
"state": "GA",
"postal_code": "300417623",
"telephone_number": "770-886-3842",
"fax_number": "770-886-3843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 NORTHSIDE BLVD",
"address_2": "SUITE 2800",
"city": "CUMMING",
"state": "GA",
"postal_code": "300417623",
"telephone_number": "770-886-3842",
"fax_number": "770-886-3843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAKI",
"first_name": "ROSHAN",
"middle_name": "N",
"credential": "R.D.,L.D.,CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-27",
"last_updated": "2010-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD002087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.