Souha S Hakim, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301068721 Issued in MI

Practice address

1418 E Michigan Ave
Jackson, MI 49202-3518

Phone

(517) 783-1779

Fax

(517) 783-1899

NPI assigned

Jul 25, 2006

Last updated

Jan 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Interoperability endpoints

• Direct secure messaging: shakim444130@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Center of Jackson

  • Pediatrics Physician
  • Jackson, MI
  • NPI 1659523876
  NPD Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1699798249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023518",
            "telephone_number": "517-783-1779",
            "fax_number": "517-783-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023518",
            "telephone_number": "517-783-1779",
            "fax_number": "517-783-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKIM",
        "first_name": "SOUHA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301068721",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301068721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shakim444130@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "205 N East Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Hackworth
• Scott Alan Hager
• Tameka Haines
• Tabitha Mae Hair
• Gretchen Hakenjos
• Ruby Halcomb
• Danielle Hale
• McKenna Haley
• Christine Hall-Reed, L.M.S.W.,A.C.S.W.
• Chad Hall, PHARMD

• Pediatrics Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.