Sodasavanh Joy Khamsoukthavong

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

200570006CNS Issued in OR

Practice address

501 N Graham St Ste 220
Portland, OR 97227-2014

Phone

(503) 413-4710

Fax

(503) 413-7148

NPI assigned

May 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 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 2

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
• Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

92.83 of 100Reported as group

Quality

96.26

Promoting interoperability

100

Improvement activities

40

Cost

79.84

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skhamsoukthavong41312@direct.lhs.org

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  OR

  Medicare reassignment Care Compare group NPD
• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  WA

  Medicare reassignment Care Compare group NPD
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358

  OR

  Medicare reassignment NPD
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216

  OR

  Medicare reassignment NPD
• Legacy Clinics LLC

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  Care Compare group NPD
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  Care Compare group NPD
• Legacy Salmon Creek Hospital

  • Radiation Oncology Clinic/Center
  • Vancouver, WA
  • NPI 1609175660
  Care Compare group
• Legacy Salmon Creek Hospital

  • Community/Retail Pharmacy
  • Vancouver, WA
  • NPI 1790705275
  Care Compare group
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003367491
  NPD
• Legacy Emanuel Hospital & Health Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1609896174
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108
  NPD

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

• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003367491

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1295756898

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1508212283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 220",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272014",
            "telephone_number": "503-413-4710",
            "fax_number": "503-413-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 220",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272014",
            "telephone_number": "503-413-4710",
            "fax_number": "503-413-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMSOUKTHAVONG",
        "first_name": "SODASAVANH",
        "middle_name": "JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OR",
            "license": "200570006CNS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney L. Khalsa, DC
• Hari Dass Singh Khalsa, D.C.
• Shabd Khalsa, LPC
• Sita Khalsa
• Megan Khamsoukthavong, RPH, PHARMD
• Aamna Khan, MD
• Abigail Defrees May Khan, MD
• Akram Khan, M.D.
• Hufssa Khan
• Johanna Haleema Ethel Khan, PHARMD, MD

• All providers in Portland, OR
• Clinical Nurse Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.