Melissa Tucker Khan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0005378 Issued in MD

Practice address

6475 Jimmy Carter Blvd Ste 200
Norcross, GA 30071-1734

Phone

(770) 242-7744

NPI assigned

Apr 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1710168117

  GA

  Medicare reassignment
• American Current Care P.a.

  • Urgent Care Clinic/Center
  • Dalton, GA
  • NPI 1750194197
  NPD

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1295155679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S CHARLES ST",
            "address_2": "#150",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 JIMMY CARTER BLVD STE 200",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711734",
            "telephone_number": "770-242-7744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S Charles St",
            "address_2": "#150",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212012725",
            "country_code": "US",
            "telephone_number": "410-752-3010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 Ben Hur Ave",
            "address_purpose": "LOCATION",
            "city": "Willoughby",
            "state": "OH",
            "postal_code": "440946398",
            "country_code": "US",
            "telephone_number": "440-975-4185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MELISSA",
        "middle_name": "TUCKER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sosena Kebede, MD
• Keen Behavioral Solutions LLC
• Isabelle Kelly
• Donald Craig Kerley, PSY.D.
• Wardah Khalid, PA-C
• Viswanatha Kharidi, MD
• Raymond S Kiertekles, PH.D.
• Ann Jungsun Kim, APRN
• Gene Young Kim
• June J Kim, DMD

• Physician Assistant in Norcross, GA
• Providers in Norcross, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.