Individual provider Active NPI

Khalilah Muhammad, M.D.

  • Internal Medicine Physician
  • Decatur, GA
National Provider Identifier
1447782628
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
86822 Issued in GA
Practice address
2124 Candler Rd
Decatur, GA 30032-5572
Phone
(404) 836-0272
Fax
(404) 666-0038
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 86822 GA Primary
Internal Medicine Physician 207R00000X 55022 KY

Addresses

Primary practice location

2124 Candler Rd
Decatur, GA 30032-5572

Mailing address

2124 Candler Rd
Decatur, GA 30032-5572
Phone (404) 836-0272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, GA2 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

Enrollment IDStateProvider typePAC IDDetails
I20210323001182 KY Practitioner - Internal Medicine 2365859162 Reassigns benefits to 1 organization
I20231219002785 GA Practitioner - Internal Medicine 2365859162 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86822GAMDInternal Medicine Physician
55022KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Ky Holding, LLC CurrentSince Jan 1, 2022 Accepting new patients
PMR Georgia Holding, LLC CurrentSince Jan 1, 2024 Accepting new patients
Jencare Neighborhood Medical Center West End, LLC PastSince Aug 4, 2014 Accepting new patients
PMR Ky Holding, LLC Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310
Phone (404) 419-0184

2124 Candler Rd
Decatur, GA 30032
Phone (404) 836-0272

3939 7th Street Rd
Louisville, KY 40216
Phone (502) 775-1211

2406 W Broadway
Louisville, KY 40211
Phone (502) 775-1211

8019 Dixie Hwy
Ste 101
Louisville, KY 40258
Phone (502) 333-3121

1918 Hikes Ln
#102
Louisville, KY 40218
Phone (502) 473-4067

Organizations & group practices 4

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1447782628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325572",
            "telephone_number": "404-836-0272",
            "fax_number": "404-666-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325572",
            "telephone_number": "404-836-0272",
            "fax_number": "404-666-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHAMMAD",
        "first_name": "KHALILAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "86822",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "55022",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.