Khizer Khurshid Ahmad, MD
Individual provider Active NPI Pediatrics Physician · Canton, GA
NPI 1689635161 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1689635161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 042511 (GA)
- Practice address
- 15 Reinhardt College Pkwy
BLDG 100 Suite 100
Canton, GA 30114 - Phone
- (770) 479-1985
- Fax
- (770) 479-4839
- NPI assigned
- Apr 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140123001163 | AL | Practitioner - Pediatric Medicine | 9739317637 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME74728 | FL | MD | Pediatrics Physician |
| 01046250 | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Head Clinic LLC | Current |
Accepting new patients | |
| Horizon Healthcare LLC | Current |
Accepting new patients | |
| Valley Head Clinic LLC | Current |
Accepting new patients | |
| Premier Medical Clinic LLC | Current |
Accepting new patients | |
| Piedmont Rockdale Hospital Inc. | Past | Accepting new patients | |
| Piedmont Mountainside Hospital, Inc. | Past | Accepting new patients |
Locations
205 Grand Ave NW
Ste B
Fort Payne, AL 35967
Phone (256) 979-1515
6110 County Road 88
Pisgah, AL 35765
Phone (256) 451-1250
506 Harley St
Scottsboro, AL 35768
Phone (256) 259-1234
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 042511 | GA | Yes |
| Pediatrics Physician | 208000000X | 01046250 | IN | |
| Pediatrics Physician | 208000000X | ME74728 | FL |
Addresses
Primary practice location
15 Reinhardt College Pkwy
BLDG 100 Suite 100
Canton, GA 30114
Mailing address
15 Reinhardt College Pkwy
BLDG 100 Suite 100
Canton, GA 30114
Phone (770) 479-1985
Other providers in Canton, GA
- Advanced Center for Joint Replacement Cherokee, LLC
- Advanced Urology Institute of Georgia PC
- Advanced Wound and Ostomy Solutions
- Aegis Group Practice LLC
- Lauren Galbraith Agee
- Maida Imtiaz Ahmad
- Ahs Surgery Center Canton LLC
- Mohammed Jaafar Atta Al Fayyadh
- Tamim Mohamad Al-Kharrat
- Francheska Desravines Alcide
All providers in Canton, GA · Pediatrics Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.