Mohammad Khan, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

91770 Issued in GA

Practice address

1180 Ernest W Barrett Pkwy NW Ste 102a
Kennesaw, GA 30144-4534

Phone

(470) 956-9171

Fax

(770) 794-6652

NPI assigned

Apr 4, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkhan492868@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Cardiovascular Medicine, LLC

  • Cardiovascular Disease Physician
  • Marietta, GA
  • NPI 1457320319
  NPD (past)

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1700249018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 ERNEST W BARRETT PKWY NW STE 102A",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444534",
            "telephone_number": "470-956-9171",
            "fax_number": "770-794-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 ERNEST W BARRETT PKWY NW STE 102A",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444534",
            "telephone_number": "470-956-9171",
            "fax_number": "770-794-6652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4581 S Cobb Dr SE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300806906",
            "country_code": "US",
            "telephone_number": "470-956-9171",
            "fax_number": "770-999-2520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMAD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "91770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhan492868@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1180 Ernest W Barrett Pkwy NW Ste 102A",
            "city": "Kennesaw",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301444534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason Kern
• Steven Keus, ATC
• Finneas Christopher Key
• Kelshia Voshonda Keys
• Keystone Surgical Associates
• Mojgan Khatami, MD
• Catherine Njeri Kiarie, NP-C
• Holly Rae Kibbe, MS, BCBA
• Morgan Kidd, RBT
• Alice Kihara

• Pediatric Cardiology Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Pediatric Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.