Individual provider Active NPI

Chaouki K Khoury, MD, MS

  • Neurology with Special Qualifications in Child Neurology Physician
  • Atlanta, GA
National Provider Identifier
1831223049
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
083596 Issued in GA
Practice address
5887 Glenridge Dr Ste 140
Atlanta, GA 30328-6191
Phone
(678) 705-7341
Fax
(678) 973-0578
NPI assigned
Mar 16, 2007
Last updated
Nov 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 22296 OK
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X P1189 TX
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 083596 GA Primary

Addresses

Primary practice location

5887 Glenridge Dr Ste 140
Atlanta, GA 30328-6191

Mailing address

5887 Glenridge Dr Ste 140
Atlanta, GA 30328-6191
Phone (678) 705-7341

Other practice location 1

6301 Gaston Ave Ste 100W
Dallas, TX 75214-6273
Phone (214) 827-3610

Other identifiers 1

IdentifierTypeStateIssuer
291823701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
083596GAMDNeurology with Special Qualifications in Child Neurology Physician
P1189TXMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Headache Specialists PastSince Nov 16, 2021 Accepting new patients
Texas Neurology, P.a. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBAABA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1831223049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5887 GLENRIDGE DR STE 140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303286191",
            "telephone_number": "678-705-7341",
            "fax_number": "678-973-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5887 GLENRIDGE DR STE 140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303286191",
            "telephone_number": "678-705-7341",
            "fax_number": "678-973-0578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6301 Gaston Ave Ste 100W",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752146273",
            "country_code": "US",
            "telephone_number": "214-827-3610",
            "fax_number": "214-821-4017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "CHAOUKI",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "OK",
            "license": "22296",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "P1189",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "GA",
            "license": "083596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291823701",
            "state": "TX"
        }
    ],
    "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 Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.