Individual provider Active NPI

Dajah Souife, CRNP

  • Family Nurse Practitioner
  • Madison, AL
National Provider Identifier
1053917856
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-156220 Issued in AL
Practice address
121 Continental Dr Apt 219
Madison, AL 35758-4800
Phone
(504) 442-0324
NPI assigned
Dec 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1-156220 AL Primary

Addresses

Primary practice location

121 Continental Dr Apt 219
Madison, AL 35758-4800

Mailing address

121 Continental Dr Apt 219
Madison, AL 35758-4800
Phone (504) 442-0324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929003313 AL Practitioner - Nurse Practitioner 7810394111 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Single Specialty CurrentSince Jun 22, 2021 Accepting new patients
Innova Primary Care, PC Single Specialty CurrentSince Dec 13, 2023 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

247 Chateau Dr SW
Huntsville, AL 35801
Phone (256) 533-9393

145 Research Blvd
Ste 100
Madison, AL 35758
Phone (256) 882-1510

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1053917856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CONTINENTAL DR APT 219",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357584800",
            "telephone_number": "504-442-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CONTINENTAL DR APT 219",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357584800",
            "telephone_number": "504-442-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUIFE",
        "first_name": "DAJAH",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-156220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.