Individual provider Active NPI

Nousheen Khetani, AA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1659005981
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
11203 Issued in GA
Practice address
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone
(754) 247-4059
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 11203 GA Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Atlanta, GA 30309-1281

Mailing address

2510 Larson Creek CV
Duluth, GA 30097-7417
Phone (404) 547-6898

Other practice location 1

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1000

Other practice location 2

1800 Howell Mill Rd NW Ste 250
Atlanta, GA 30318-2593
Phone (404) 537-4910

Other practice location 3

1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone (404) 351-1745

Other practice location 4

775 Poplar Rd Ste Ll20
Newnan, GA 30265-8306
Phone (770) 253-1912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102001993 GA Practitioner - Anesthesiology Assistant 3779950878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Anesthesia Professionals, LLCGroup PAC ID 5496134348, 543 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
11203GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Anesthesia Associates, L.L.C CurrentSince Sep 19, 2022 Accepting new patients
North Atlanta Anesthesia Professionals, LLC CurrentSince Jan 3, 2024 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1800 Howell Mill Rd NW
Ste 250
Atlanta, GA 30318
Phone (404) 537-4910

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

775 Poplar Rd
Ste LL20
Newnan, GA 30265
Phone (770) 253-1912

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1659005981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 LARSON CREEK CV",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300977417",
            "telephone_number": "404-547-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "754-247-4059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "745 Poplar Rd",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302651618",
            "country_code": "US",
            "telephone_number": "770-400-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Howell Mill Rd NW Ste 250",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303182593",
            "country_code": "US",
            "telephone_number": "404-537-4910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 Highway 54 W",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302144526",
            "country_code": "US",
            "telephone_number": "404-351-1745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "775 Poplar Rd Ste Ll20",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302658306",
            "country_code": "US",
            "telephone_number": "770-253-1912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHETANI",
        "first_name": "NOUSHEEN",
        "credential": "AA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "11203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.