Mali Khamissi Sobi

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

82852 Issued in GA

Practice address

4787 Austell Rd
Austell, GA 30106-2001

Phone

(770) 875-6870

NPI assigned

Apr 5, 2017

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

Other identifiers 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

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Medical Office ForceGroup PAC ID 9335481951, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aplusclinic.malikhamissisobi@152976.advancedmd-direct.com

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.

• A Plus Clinic

  • Family Medicine Physician
  • Austell, GA
  • NPI 1477158541

  Single Specialty

  Medicare reassignment NPD Authorized official
• Medical Office Force

  • Internal Medicine Physician
  • Athens, GA
  • NPI 1508378613

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1831622984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 RIDGECREST LN SE",
            "address_2": "APT/SUITE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802664",
            "telephone_number": "770-875-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4787 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301062001",
            "telephone_number": "770-875-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMISSI SOBI",
        "first_name": "MALI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "82852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA MEDICAL LICENSE",
            "identifier": "82852",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy H. Kendrick, PA
• Kennestone Hospital, Inc
• Kennestone Hosptial, Inc.
• Kevin Wayne Kersee Jr., D.C.
• Christine M Keyser, DMD
• Mohammad Raza Khan
• Muhammad Aizaz Mohsin Khan, MBCHB
• Nabeel A Khan, MD
• Anshika Payal Khare, MD
• Agnes Kim, PT, DPT

• Family Medicine Physician in Austell, GA
• Providers in Austell, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.
• 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.