Individual provider Active NPI

Christina Samar Khal, MSOT, OTR/L

  • Occupational Therapist
  • Augusta, GA
National Provider Identifier
1679960561
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006175 Issued in GA
Practice address
2258 Wrightsboro Rd
Suite 250
Augusta, GA 30904-4887
Phone
(706) 724-6543
Fax
(206) 350-9023
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT006175 GA Primary
Mental Health Occupational Therapist 225XM0800X OT006175 GA
Neurorehabilitation Occupational Therapist 225XN1300X OT006175 GA
Physical Rehabilitation Occupational Therapist 225XP0019X OT006175 GA

Addresses

Primary practice location

2258 Wrightsboro Rd
Suite 250
Augusta, GA 30904-4887

Mailing address

2258 Wrightsboro Rd
Suite 250
Augusta, GA 30904-4887
Phone (706) 724-6543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230112000089 GA Practitioner - Occupational Therapist in Private Practice 5698145423 Reassigns benefits to 4 organizations
I20230629002751 SC Practitioner - Occupational Therapist in Private Practice 5698145423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Swallowing DiagnosticsGroup PAC ID 7719239359, 14 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Smyrna, GA 30082
Phone (301) 275-4057

255 Vaughn Dr
Alpharetta, GA 30009-2415
Phone (770) 521-9707

3725 Wheeler Rd
Augusta, GA 30909-6623
Phone (706) 364-3325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6749SCMDPhysical Therapist
OT006175GAMDMental Health Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Jun 3, 2024 Accepting new patients
Southeastern Swallowing Diagnostics CurrentSince May 1, 2025 Accepting new patients
Fox Rehabilitation Ga, LLC Occupational Therapist CurrentSince May 1, 2023 Accepting new patients
Fox Rehabilitation Services of South Carolina, LLC Occupational Therapist CurrentSince May 1, 2023 Accepting new patients
Functional Pathways Preferred of Tennessee LLC Occupational Therapist CurrentSince Jan 1, 2023 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jun 3, 2024 Accepting new patients

Locations

100 Washington Commons Dr
Evans, GA 30809
Phone (706) 426-8136

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

7 Carnegie Plz
Cherry Hill, NJ 08003

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

Organizations & group practices 6

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": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1679960561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2258 WRIGHTSBORO RD",
            "address_2": "SUITE 250",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044887",
            "telephone_number": "706-724-6543",
            "fax_number": "206-350-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2258 WRIGHTSBORO RD",
            "address_2": "SUITE 250",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044887",
            "telephone_number": "706-724-6543",
            "fax_number": "206-350-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAL",
        "first_name": "CHRISTINA",
        "middle_name": "SAMAR",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006175",
            "primary": true
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "GA",
            "license": "OT006175",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "GA",
            "license": "OT006175",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "GA",
            "license": "OT006175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.