NPIMap

Individual provider Active NPI

Samara Mujeeb Khalique, MD

  • Rheumatology Physician
  • Rockingham, VA
National Provider Identifier
1598054025
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
0101258427 Issued in VA
Practice address
2006 Health Campus Dr
Rockingham, VA 22801-8679
Phone
(540) 689-5700
Fax
(757) 431-7146
NPI assigned
Apr 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116027786 VA
Rheumatology Physician 207RR0500X 0101258427 VA Primary

Addresses

Primary practice location

2006 Health Campus Dr
Rockingham, VA 22801-8679

Mailing address

RMH Medical Group
PO Box 1430
Harrisonburg, VA 22803
Phone (540) 689-5700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171025002271 VA Practitioner - Rheumatology 3779879895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Virginia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

3 Riverside Cir
Roanoke, VA 24016-4955
Phone (540) 224-5170

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116027786VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Nov 8, 2021 Accepting new patients
Carilion Medical Center CurrentSince Nov 8, 2021 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

3 Riverside Cir
Roanoke, VA 24016

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

Interoperability endpoints

  • Direct secure messaging: skhalique308986@direct.sentara.net

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1598054025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RMH MEDICAL GROUP",
            "address_2": "PO BOX 1430",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "22803",
            "telephone_number": "540-689-5700",
            "fax_number": "757-431-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 HEALTH CAMPUS DR",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018679",
            "telephone_number": "540-689-5700",
            "fax_number": "757-431-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIQUE",
        "first_name": "SAMARA",
        "middle_name": "MUJEEB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116027786",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "0101258427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, VA

Sources for this page

Verify at the official NPI Registry.