NPIMap

Individual provider Active NPI

Khaldoun Soudan, MD

  • Nephrology Physician
  • Alexandria, LA
National Provider Identifier
1164411815
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
204504 Issued in LA
Practice address
2220 Worley Dr
Alexandria, LA 71301-3600
Phone
(318) 704-0001
Fax
(318) 704-0002
NPI assigned
Oct 17, 2005
Last updated
Jul 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 204504 LA Primary

Addresses

Primary practice location

2220 Worley Dr
Alexandria, LA 71301-3600

Mailing address

2220 Worley Dr
Alexandria, LA 71301-3600
Phone (318) 704-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110617000593 LA Practitioner - NephrologyPractitioner - Internal Medicine 7315966322 Reassigns benefits to 5 organizations
I20200409003810 MS Practitioner - Nephrology 7315966322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cenla Kidney Specialists LLCGroup PAC ID 0042543035, 7 clinicians
Hospital Service District 2 of Lasalle ParishGroup PAC ID 3971596164, shared by 3 NPIs, 13 clinicians
CLHG-Winn, LLCGroup PAC ID 6002198736, shared by 5 NPIs, 17 clinicians

Practice addresses (Care Compare)

151 Jefferson Davis Blvd
Suite a
Natchez, MS 39120-5140
Phone 6012733554102

187 9TH St
Jena, LA 71342-3900
Phone (318) 992-9200

2220 Worley Dr
Alexandria, LA 71301-3600
Phone 3187040001102

301 W Boundary Ave
Winnfield, LA 71483-3427
Phone (318) 648-3000

301 W Boundary Ave B
Winnfield, LA 71483-3427
Phone (318) 209-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204504LAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allegiance Hospital of Many,LLC CurrentSince Apr 7, 2024 Accepting new patients
Cenla Kidney Specialists LLC Nephrology CurrentSince Jul 1, 2019 Accepting new patients
Allegiance Hospital of Many, LLC CurrentSince Apr 7, 2024 Accepting new patients
CLHG-Winn LLC CurrentSince Nov 13, 2021 Accepting new patients
Allegiance Hospital of Many, LLC Current Accepting new patients
Franklin Parish Hospital Service Dist 1 CurrentSince Jan 31, 2021 Accepting new patients
CLHG-Winn, LLC Current Accepting new patients
Franklin Parish Hospital Service Dist 1 CurrentSince Jan 31, 2021 Accepting new patients
Louisiana Kidney Specialists CurrentSince Apr 1, 2026 Accepting new patients
Cenla Dialysis Care LLC Nephrology PastSince Jan 31, 2021 Accepting new patients

Locations

2220 Worley Dr
Alexandria, LA 71301
Phone (216) 647-3653

180 Ninth St
Jena, LA 71342
Phone (318) 992-6311

12060 Texas Hwy
#3
Many, LA 71449
Phone (318) 256-9002

240 Highland Dr
Many, LA 71449
Phone (318) 256-5691

434 E Chestnut St
Marksville, LA 71351
Phone (318) 253-2299

400 E 6th Ave
Oakdale, LA 71463
Phone (318) 335-3501

301 W Boundary Ave
Ste B
Winnfield, LA 71483
Phone (318) 209-4646

2106 Loop Rd
Winnsboro, LA 71295
Phone (318) 282-8482

151 Jefferson Davis Blvd
Ste A
Natchez, MS 39120
Phone (318) 704-0001

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGIHBD
  • Direct secure messaging: khaldoun.soudan.1@25133.direct.athenahealth.com
  • Direct secure messaging: khaldoun.soudan.1@29237.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1164411815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 WORLEY DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013600",
            "telephone_number": "318-704-0001",
            "fax_number": "318-704-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 WORLEY DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013600",
            "telephone_number": "318-704-0001",
            "fax_number": "318-704-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDAN",
        "first_name": "KHALDOUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "204504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.