Active NPI
Asra Y Khan, PA-C
- Physician Assistant
- Marietta, GA
National Provider Identifier
1497408025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001013335
- Practice address
- 45 South Ave SE Ste 5
Marietta, GA 30060-2538 - Phone
- (919) 391-7202
- NPI assigned
- Feb 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001013335 | NC | Primary |
Addresses
Primary practice location
45 South Ave SE Ste 5
Marietta, GA 30060-2538
Mailing address
5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone (919) 391-7202
Other practice location 1
5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone (919) 391-7202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
45 S Ave SE
Suite 5
Marietta, GA 30060-2538
Phone (919) 391-7202
5501 Fortunes Ridge Dr
Suite P
Durham, NC 27713-6102
Phone (919) 391-7202
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001013335 | NC | MD | Physician Assistant |
Organizations & group practices 1
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": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760227200000",
"number": "1497408025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5501 FORTUNES RIDGE DR STE P",
"city": "DURHAM",
"state": "NC",
"postal_code": "277136102",
"telephone_number": "919-391-7202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 SOUTH AVE SE STE 5",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300602538",
"telephone_number": "919-391-7202"
}
],
"practiceLocations": [
{
"address_1": "5501 Fortunes Ridge Dr Ste P",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "277136102",
"country_code": "US",
"telephone_number": "919-391-7202",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAN",
"first_name": "ASRA",
"middle_name": "Y",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-02",
"last_updated": "2025-10-12",
"certification_date": "2025-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "001013335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2025; 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.