DR. KHADIJAH STEPHEN MD
NPI 1174465231
Student in an Organized Health Care Education/Training Program in Douglasville, GA
About Dr. Khadijah Stephen Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KHADIJAH STEPHEN MD (NPI 1174465231) is an individual student in an organized health care education/training program in Douglasville, Georgia and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Khadijah Stephen Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DOUGLASVILLE, GA 30134
DOUGLASVILLE, GA 30134
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Khadijah Stephen's NPI number?
The NPI number for Khadijah Stephen is 1174465231. It was assigned to this individual provider in the NPPES registry on April 8, 2026.
Where is Khadijah Stephen located?
Khadijah Stephen practices at 6002 Professional Pkwy Ste 200, Douglasville, GA 30134. The listed phone number is (770) 968-6464.
What is Khadijah Stephen's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Khadijah Stephen enrolled in Medicare?
Yes. Khadijah Stephen is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Khadijah Stephen was last updated on April 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Khadijah Stephen, MD · NPI 1174465231
Student in an Organized Health Care Education/Training Program provider in Douglasville, Georgia. Individual provider, active in the CMS NPPES registry since April 8, 2026.
## Identity
- **NPI:** 1174465231 (Entity type: Individual)
- **Enumerated:** April 8, 2026
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 6002 PROFESSIONAL PKWY STE 200, Douglasville, GA 30134-5627
- **Phone:** (770) 968-6464
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 8, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1174465231) · Data from the CMS NPPES public registry.