Nizamuddin Khaja, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

054915 Issued in GA

Practice address

101 Quartz Dr # 103
Villa Rica, GA 30180-3255

Phone

(770) 812-3530

Fax

(770) 812-3531

NPI assigned

Jul 2, 2006

Sex

Male

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1986

Medicare assignment

May accept Medicare assignment

Group practices

TMC-Behavioral Health of West GeorgiaGroup PAC ID 2163714635, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• TMC-Behavioral Health of West Georgia

  • Geriatric Psychiatry Physician
  • Villa Rica, GA
  • NPI 1356795462

  GA

  Medicare reassignment Care Compare group NPD
• Highland Rivers Community Service Board

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1447256243

  GA

  Medicare reassignment NPD
• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1164585543
  NPD
• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1417010885
  NPD
• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787

  Psychiatry

  NPD (past)
• Parkwest Medical Center

  • Psychiatric Hospital
  • Louisville, TN
  • NPI 1558343566
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• TMC/Villa Rica Hospital, Inc

  • General Acute Care Hospital
  • Villa Rica, GA
  • NPI 1851388748

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1295764009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR STE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-812-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 QUARTZ DR # 103",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301803255",
            "telephone_number": "770-812-3530",
            "fax_number": "770-812-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAJA",
        "first_name": "NIZAMUDDIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "054915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Iyana Kimbrough
• Lorna Kirui, PHARMD
• Caroline L Knott, LPC

• All providers in Villa Rica, GA
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.