Mirza W Ahmed, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

31393 Issued in KY

Practice address

1210 W 5TH St
Suite 100
London, KY 40741-2112

Phone

(606) 864-4040

Fax

(606) 864-3500

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 10

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, KY2 enrollments

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 2

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Georgia Clinic, PC 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/EBABED/Endpoint/EBABED
• Direct secure messaging: mirza.ahmed@gadirect.net

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.

• Georgia Clinic, PC

  • Multi-Specialty Clinic/Center
  • Dunwoody, GA
  • NPI 1609816123

  GA

  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Kentucky Specialty Care LLC

  • Surgery Physician
  • Paducah, KY
  • NPI 1700408093

  Cardiovascular Disease, KY

  Medicare reassignment NPD
• Express Diagnostic Imaging

  • Radiology Clinic/Center
  • Houston, TX
  • NPI 1689377947
  NPD Authorized official
• Atlanta Cardiac & Vascular Specialties, LLC

  • Cardiovascular Disease Physician
  • Decatur, GA
  • NPI 1861746430

  Cardiovascular Disease

  NPD (past) Authorized official
• Georgia Cardiology Center, LLC

  • Cardiovascular Disease Physician
  • Macon, GA
  • NPI 1619992138

  Cardiovascular Disease

  NPD (past) Authorized official
• Labgen

  • Clinical Medical Laboratory
  • Houston, TX
  • NPI 1124708532
  NPD (past) Authorized official
• Mercy Health Physicians Kentucky Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Paducah, KY
  • NPI 1043088347
  NPD
• Dekalb Medical Center, Inc.

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  NPD
• Mercy Health Physicians Kentucky LLC

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922243690

  Cardiovascular Disease

  NPD (past)
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)
• Health Services of Central Georgia, Inc

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Cardiovascular Disease

  NPD (past)
• North Atlanta Professional Services LLC

  • Psychologist
  • Atlanta, GA
  • NPI 1316959869

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1376653634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERY STREET",
            "address_2": "SUITE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021434",
            "telephone_number": "502-315-1458",
            "fax_number": "502-479-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 5TH ST",
            "address_2": "SUITE 100",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407412112",
            "telephone_number": "606-864-4040",
            "fax_number": "606-864-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Trillium Way Ste 210",
            "address_purpose": "LOCATION",
            "city": "Corbin",
            "state": "KY",
            "postal_code": "407018426",
            "country_code": "US",
            "telephone_number": "606-523-3038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MIRZA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "31393",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "034761",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "31393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000715448AA",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000715448AC",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000715448AD",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000715448AP",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELL CARE (MEDICAID CMO)",
            "identifier": "319761",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS EDI #",
            "identifier": "708612",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100366800",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR #",
            "identifier": "607859800",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PROV #",
            "identifier": "P00180131",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000715448AB",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mahmed28118@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2 Trillium Way Ste 210",
            "city": "Corbin",
            "state": "KY",
            "country_code": "US",
            "postal_code": "407018426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Derrick Adams, M.D.
• Mark S. Adams, M.D.
• Advamed Health LLC
• Advanced Medical LLC
• Advanced Vascular Institute
• Air Evac EMS, Inc.
• Brett Darrell Akers, D.O.
• Alan D Graham
• Daniel C Albertson, ARNP
• Alecia Shepherd Language Therapy L

• All providers in London, KY
• Interventional Cardiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.