NPIMap

Individual provider Active NPI

Ahmed A. Khan, MD

  • Interventional Cardiology Physician
  • Johnson City, TN
National Provider Identifier
1639165277
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
13265 Issued in TN
Practice address
310 N State of Franklin Rd
Suite 400
Johnson City, TN 37604-6008
Phone
(423) 979-6000
Fax
(423) 979-6011
NPI assigned
Sep 20, 2005
Last updated
Feb 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13265 TN
Cardiovascular Disease Physician 207RC0000X 13265 TN
Interventional Cardiology Physician 207RI0011X 13265 TN Primary

Addresses

Primary practice location

310 N State of Franklin Rd
Suite 400
Johnson City, TN 37604-6008

Mailing address

310 N State of Franklin Rd
Suite 400
Johnson City, TN 37604-6008
Phone (423) 979-6000

Other identifiers 4

IdentifierTypeStateIssuer
3030318MedicaidTN
P01457780OtherTNRAILROAD MEDICARE
1639165277MedicaidVA
64918162MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040927000744 TN Practitioner - Cardiovascular Disease (Cardiology) 7911976089 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

310 N State of Franklin Rd
Suite 400
Johnson City, TN 37604-6051
Phone (423) 979-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting30
Pacemaker insertion or repair28

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Internal Medicine CurrentSince Oct 1, 2012 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince May 22, 2022 Accepting new patients
Wellmont Cardiology Services Cardiovascular Disease CurrentSince May 22, 2022 Accepting new patients
Wellmont Medical Associates Inc Internal Medicine CurrentSince May 22, 2022 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Oct 1, 2012 Accepting new patients
Tri-State Cardiology Past Accepting new patients
Blue Ridge Medical Management Corporation Cardiovascular Disease Past Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

310 N State of Franklin Rd
Ste 400
Johnson City, TN 37604
Phone (423) 929-7393

311 Princeton Rd
Ste 7
Johnson City, TN 37601
Phone (423) 282-3236

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

2050 Meadowview Pkwy
Kingsport, TN 37660

Organizations & group practices 8

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 7

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1639165277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 400",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046008",
            "telephone_number": "423-979-6000",
            "fax_number": "423-979-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 400",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046008",
            "telephone_number": "423-979-6000",
            "fax_number": "423-979-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AHMED",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "13265",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "13265",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "13265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3030318",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01457780",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639165277",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64918162",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.