Individual provider Active NPI

Mujeeb A Jan, MD

  • Cardiovascular Disease Physician
  • Villa Rica, GA
National Provider Identifier
1326055278
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
054226 Issued in GA
Practice address
705 Dallas Hwy
Ste 104
Villa Rica, GA 30180-1247
Phone
(404) 778-5543
NPI assigned
Aug 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 054226 GA Primary

Addresses

Primary practice location

705 Dallas Hwy
Ste 104
Villa Rica, GA 30180-1247

Mailing address

705 Dallas Hwy
Ste 104
Villa Rica, GA 30180-1247
Phone (404) 778-5543

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040715000352 GA Practitioner - Cardiovascular Disease (Cardiology) 5597744433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

200 Allen Memorial Dr
Bremen, GA 30110-2012
Phone (770) 812-9666

601 Dallas Hwy
Villa Rica, GA 30180-1202
Phone (770) 812-9666

690 Dallas Hwy
Villa Rica, GA 30180-1263

690 Dallas Hwy 207a
Villa Rica, GA 30180-1263
Phone (770) 456-3646

705 Dallas Hwy
Villa Rica, GA 30180-1243

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

706 Dixie St
Carrollton, GA 30117-3819

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Cardiovascular Disease CurrentSince Apr 1, 2004 Accepting new patients
Tanner Medical Group Inc Cardiovascular Disease CurrentSince Nov 15, 2011 Accepting new patients
TMC Children's Healthcare of West Georgia Past Accepting new patients
Providence Health & Services-Wa Past Accepting new patients
Inland Cardiology Associates, P.S. Cardiovascular Disease PastSince Aug 25, 2014 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

157 Clinic Ave
Ste 302A
Carrollton, GA 30117
Phone (770) 812-5886

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326055278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 DALLAS HWY",
            "address_2": "STE 104",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801247",
            "telephone_number": "404-778-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DALLAS HWY",
            "address_2": "STE 104",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801247",
            "telephone_number": "404-778-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAN",
        "first_name": "MUJEEB",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "054226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.