Active NPI
Siham Muntasser, M.D.
- Child & Adolescent Psychiatry Physician
- Winston Salem, NC
National Provider Identifier
1245205772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 2012-02425
- Practice address
- 791 Jonestown Rd
Department of Psychiatry and Behavioral Medicine
Winston Salem, NC 27103-1252 - Phone
- (304) 282-2359
- NPI assigned
- Feb 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 21382 | WV | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 2012-02425 | NC | Primary |
Addresses
Primary practice location
791 Jonestown Rd
Department of Psychiatry and Behavioral Medicine
Winston Salem, NC 27103-1252
Mailing address
791 Jonestown Rd
Winston Salem, NC 27103-1252
Phone (304) 282-2359
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810003675 | Medicaid | WV | |
| 5922640 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21382 | WV | MD | Psychiatry Physician |
| 2012-02425 | NC | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairmont Physicians Inc | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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": "1140393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1245205772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "791 JONESTOWN RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031252",
"telephone_number": "304-282-2359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "791 JONESTOWN RD",
"address_2": "DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL MEDICINE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031252",
"telephone_number": "304-282-2359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNTASSER",
"first_name": "SIHAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-20",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WV",
"license": "21382",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NC",
"license": "2012-02425",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810003675",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5922640",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.