Jeremy S Khan, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

GA054439 Issued in GA

Practice address

759 Peachtree Pkwy
Suite 3
Cumming, GA 30041-9350

Phone

(404) 804-0024

Fax

(470) 237-2457

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jkhan8383@choa.gadirect.net

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1497794135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 PEACHTREE PKWY",
            "address_2": "SUITE 3",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419350",
            "telephone_number": "404-804-0024",
            "fax_number": "470-237-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 PEACHTREE PKWY",
            "address_2": "SUITE 3",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419350",
            "telephone_number": "404-804-0024",
            "fax_number": "470-237-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "JEREMY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "054439",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "GA054439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "608617837A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregg H Kennedy, M.D.
• Tabitha Anne Kephart, CSA
• Kerri Aune, M.Ed. CCC-SLP, LLC
• Clayton Keye, PMHNP
• Roshan N Khaki, R.D.,L.D.,CDE
• Omar T Khan, DO
• Adam M Khanu, PA-C
• Ethan S Khazali, DMD
• Elaheh Kheirbakhsh, PAC
• Vikram Khetpal, MD

• Cardiovascular Disease Physician in Cumming, GA
• Providers in Cumming, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.