Sophia Annemarie Khawly, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10006540 Issued in MA

Practice address

24 N Westfield St
Feeding Hills, MA 01030-1606

Phone

(413) 831-7831

NPI assigned

Oct 17, 2012

Last updated

Jun 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, CA, VA, OH, CO, MA6 enrollments

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 6

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 26)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909
  Medicare reassignment NPD
• Dedicated Columbus Ohio, LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1538798483

  OH

  Medicare reassignment NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  Medicare reassignment NPD
• Family Health Centers of San Diego, Inc

  dba Logan Heights Family Health Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Lincoln Community Hospital

  • Critical Access Hospital
  • Hugo, CO
  • NPI 1720107519
  Medicare reassignment NPD
• PMR Virginia Holding, LLC

  dba Jencare Senior Medical Centers of Virginia

  • Specialist
  • Miami Gardens, FL
  • NPI 1083167001

  VA

  Medicare reassignment NPD
• Archwell Health Medical of Florida, LLC

  • Internal Medicine Physician
  • Venice, FL
  • NPI 1497453450
  NPD
• Dedicated Columbus Ohio, LLC

  dba Dedicated Senior Medical Center Morse Road

  • Non-Pharmacy Dispensing Site
  • Columbus, OH
  • NPI 1932660438
  NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD
• Family Health Centers of San Diego Inc

  dba Rice Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Chula Vista, CA
  • NPI 1083959464
  NPD
• Family Health Centers of San Diego, Inc

  dba Chula Vista Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Chula Vista, CA
  • NPI 1346480837
  NPD
• First Quality Medical Center Corporation

  • General Practice Physician
  • Miami, FL
  • NPI 1568708477
  NPD

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1144573056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "941-357-7950",
            "fax_number": "941-840-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 N WESTFIELD ST",
            "city": "FEEDING HILLS",
            "state": "MA",
            "postal_code": "010301606",
            "telephone_number": "413-831-7831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2210 Main St",
            "address_purpose": "LOCATION",
            "city": "Dunedin",
            "state": "FL",
            "postal_code": "34698",
            "country_code": "US",
            "telephone_number": "727-615-3133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2260 Morse Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432295858",
            "country_code": "US",
            "telephone_number": "614-702-7899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10101 W Flagler St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331741808",
            "country_code": "US",
            "telephone_number": "305-904-0838",
            "fax_number": "305-904-0838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 Landis Ave",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919102628",
            "country_code": "US",
            "telephone_number": "619-515-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 53rd Ave E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342034249",
            "country_code": "US",
            "telephone_number": "941-357-7950",
            "fax_number": "941-840-1003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 N Wilson Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432041214",
            "country_code": "US",
            "telephone_number": "614-702-7915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAWLY",
        "first_name": "SOPHIA",
        "middle_name": "ANNEMARIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0029313",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9323668",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "10006540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014578000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florence Johnson, LMHC
• Jeanne Diane Johnson, MD
• Jonathan Jordan
• Diane M Juzba, BCBA
• Hafiza Ayesha Khalil, MD
• Michele Anne Korona
• Emiley Ann Krupa, PA-C
• Ramachandran Kuppuswamy, MD
• Olivia M Labonte
• Linda Lasorsa

• Family Nurse Practitioner in Feeding Hills, MA
• Providers in Feeding Hills, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.