Awan Khondoker Rahman, D.O.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

95368 Issued in GA

Practice address

1514 Vernon Rd
Lagrange, GA 30240-4131

Phone

(706) 882-1411

Fax

(770) 999-2819

NPI assigned

Apr 30, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, GA2 enrollments

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 2

Specialty

Pulmonary Disease

Education

Philadelphia College of Osteopathic Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awan.rahman@slpg.direct-sluhn.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

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Gslpg, Inc

  • Specialist
  • Orwigsburg, PA
  • NPI 1366006702
  Medicare reassignment NPD
• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• St Luke's Physician Group Inc

  dba St. Luke's Primary Care Orwigsburg

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke's Physician Group, Inc.

  dba St. Luke's General Surgery Bethlehem

  • Surgery Physician
  • Fountain Hill, PA
  • NPI 1689716375
  NPD
• West Georgia Medical Center, Inc.

  dba WellStar West Georgia Medical Center

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• West Georgia Medical Center, Inc.

  dba WellStar West Georgia Medical Center

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144
  Care Compare affiliation

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

{
    "created_epoch": "1493510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1942735758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-882-1411",
            "fax_number": "770-999-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-882-1411",
            "fax_number": "770-999-2819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Ostrum St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180151000",
            "country_code": "US",
            "telephone_number": "484-526-4644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "AWAN",
        "middle_name": "KHONDOKER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-30",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT017698",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "95368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arahman527302@directwellstar.org",
            "affiliation": "N",
            "address_1": "1514 Vernon Rd",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302404131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaitlin Pupo, M.S., BCBA
• Amy Purdy, PT
• R. J Shepherd II, Inc (Better Home Health Care of GA)
• Radiology Associates of Elberton, L.L.C.
• James Eric Ragan II, M.D.
• Rainey Professional Association
• Jamie B Raisor, ARNP
• Angampally G Rajeev, MD
• Kalyani Rajeev, MD
• Vinayak Ramanath, MD

• Pulmonary Disease Physician in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Pulmonary Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.