Individual provider Active NPI

Souha Haydoura, MD

  • Infectious Disease Physician
  • Murray, UT
National Provider Identifier
1740419274
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
78900101205 Issued in UT
Practice address
5121 S Cottonwood St Ste 350
Murray, UT 84107-5701
Phone
(801) 507-7000
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 78900101205 UT Primary

Addresses

Primary practice location

5121 S Cottonwood St Ste 350
Murray, UT 84107-5701

Mailing address

5121 S Cottonwood St Ste 350
Murray, UT 84107-5701
Phone (801) 507-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20200825002967 UT Practitioner - Infectious DiseasePractitioner - Internal Medicine 6204060403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

5171 S Cottonwood St
Suite 305
Murray, UT 84107-5704
Phone (801) 507-9310

5171 S Cottonwood St
Suite 350
Murray, UT 84107-5733
Phone (801) 507-9390

Hospital & facility affiliations

  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010
  • LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
  • Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78900101205UTMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Internal Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Jul 6, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 1, 2021 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 6, 2020 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5171 S Cottonwood St
Ste 350
Salt Lake City, UT 84107
Phone (801) 507-2831

5171 S Cottonwood St
Ste 305
Salt Lake City, UT 84107
Phone (801) 507-9310

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

Organizations & group practices 5

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 3

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1740419274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST STE 350",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST STE 350",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDOURA",
        "first_name": "SOUHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "UT",
            "license": "78900101205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.