NPIMap

Individual provider Active NPI

Tamim Mohamad Al-Kharrat, MD

  • Specialist
  • Canton, GA
National Provider Identifier
1962495267
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
045382 Issued in GA
Practice address
219 Riverstone Dr
Canton, GA 30114-5256
Phone
(770) 345-2670
Fax
(770) 345-2671
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 045382 GA Primary

Addresses

Primary practice location

219 Riverstone Dr
Canton, GA 30114-5256

Mailing address

219 Riverstone Dr
Canton, GA 30114-5256
Phone (770) 345-2670

Other identifiers 1

IdentifierTypeStateIssuer
045382OtherGASTATE LICENSE NUMBER

Other names 1

  • Dr. Tamin Kharrat Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000407 GA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3971599333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

219 Riverstone Dr
Canton, GA 30114-5256
Phone (770) 345-2670

Hospital & facility affiliations

  • Georgia Hospice Care Hospice, Acworth, GA, CCN 111673
  • Georgia Hospice Care Hospice, Gainesville, GA, CCN 111736
  • Georgia Hospice Care Hospice, Lawrenceville, GA, CCN 851510
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Nephrology LLC CurrentSince Dec 1, 2003 Accepting new patients
Tamim Kharrat MD PC Specialist CurrentSince Aug 1, 2001 Accepting new patients
Good Samaritan Health & Wellness Center Inc. Past Accepting new patients

Locations

219 Riverstone Dr
Canton, GA 30114
Phone (770) 345-2670

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Georgia Hospice CareGainesville, GA, CCN 111736 Hospice Contracted Managing Employee Apr 1, 2023
Georgia Hospice CareAcworth, GA, CCN 111673 Hospice Contracted Managing Employee Apr 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1962495267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 RIVERSTONE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145256",
            "telephone_number": "770-345-2670",
            "fax_number": "770-345-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 RIVERSTONE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145256",
            "telephone_number": "770-345-2670",
            "fax_number": "770-345-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-KHARRAT",
        "first_name": "TAMIM",
        "middle_name": "MOHAMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "045382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "045382",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMIN",
            "last_name": "KHARRAT",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.