Nikkita F Southall, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D63236 Issued in MD

Practice address

22 S Greene St
Baltimore, MD 21201-1544

Phone

(410) 328-5756

Fax

(410) 328-0267

NPI assigned

May 10, 2006

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

Other identifiers 2

Other names 1

• Nikkita F. Pessoa Former name

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• University of Maryland Physicians P.a.

  • Cardiovascular Disease Physician
  • Baltimore, MD
  • NPI 1689623175
  Medicare reassignment NPD
• University of Maryland Physicians P.a.

  • Gastroenterology Physician
  • Largo, MD
  • NPI 1619860194
  NPD
• University of Maryland Physicians P.a.

  • Infectious Disease Physician
  • Baltimore, MD
  • NPI 1720038540
  NPD
• University of Maryland Physicians PA

  • Infectious Disease Physician
  • Baltimore, MD
  • NPI 1134179955

  Internal Medicine

  NPD

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1669421293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-328-5756",
            "fax_number": "410-328-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-5756",
            "fax_number": "410-328-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "NIKKITA",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D63236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4103521-00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "647060-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKITA",
            "last_name": "PESSOA",
            "middle_name": "F.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• South Baltimore C.a.P.
• South Baltimore C.a.P. Inc.
• South Baltimore C.a.P. Inc.
• South Baltimore Eye Associtate Inc.
• South Baltinore C.a.P. Inc.
• Southeast Nursing & Rehabilitation Center
• Vickie Souther, LCSW-C
• Rachel Tarbert Southward, CRNP-F, FNP-BC,FNP-C
• Sabrina Southwick
• E. Timothy Souweine, M.D.

• Internal Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; 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.