Individual provider Active NPI

Sheema Khan, M.D.

  • Obstetrics Physician
  • Marietta, GA
National Provider Identifier
1609186360
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
72350 Issued in GA
Practice address
699 Church St NE
Ste 220
Marietta, GA 30060-1116
Phone
(770) 422-8505
Fax
(770) 424-7449
NPI assigned
Oct 15, 2010
Last updated
Oct 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 72350 GA Primary

Addresses

Primary practice location

699 Church St NE
Ste 220
Marietta, GA 30060-1116

Mailing address

699 Church St NE
Ste 220
Marietta, GA 30060-1116
Phone (770) 422-8505

Other identifiers 1

IdentifierTypeStateIssuer
003149603AMedicaidGA

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
I20141017001821 GA Practitioner - Obstetrics/Gynecology 7810118734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5041 Dallas Hwy
Suite 115
Powder Springs, GA 30127-6458
Phone (770) 422-8505

699 Church St NE
Suite 220
Marietta, GA 30060-1116
Phone (770) 422-8505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72350GAMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta OB GYN Affiliates, P.a. CurrentSince Aug 13, 2014 Accepting new patients
Marietta OB GYN Affiliates, P.a. CurrentSince Aug 13, 2014 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients
Kennestone Hospital, Inc. Past Accepting new patients

Locations

699 Church St NE
Ste 220
Marietta, GA 30060
Phone (770) 422-8505

5041 Dallas Hwy
Ste 115
Powder Springs, GA 30127
Phone (404) 274-2032

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13157/brand/3/csg/1/fhir/r4
  • Direct secure messaging: sheema.khan.1@13157.direct.athenahealth.com
  • Direct secure messaging: sheema.khan.1@25307.direct.athenahealth.com

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, 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": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1609186360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE",
            "address_2": "STE 220",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601116",
            "telephone_number": "770-422-8505",
            "fax_number": "770-424-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE",
            "address_2": "STE 220",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601116",
            "telephone_number": "770-422-8505",
            "fax_number": "770-424-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHEEMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "GA",
            "license": "72350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003149603A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.