Individual provider Active NPI

Souha Khawam, MD

  • Family Medicine Physician
  • Salem, VA
National Provider Identifier
1922070945
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101-231598 Issued in VA
Practice address
1935 W Main St
Salem, VA 24153-3109
Phone
(540) 387-0441
Fax
(540) 389-7868
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101-231598 VA Primary

Addresses

Primary practice location

1935 W Main St
Salem, VA 24153-3109

Mailing address

1935 W Main St
Salem, VA 24153-3109

Other identifiers 1

IdentifierTypeStateIssuer
010099498MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20041129000054 VA Practitioner - Family Practice 4385609619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

1935 W Main St
Salem, VA 24153-3109
Phone (540) 387-0441

1955 W Main St
Salem, VA 24153-3109
Phone (540) 387-0441

6415 Peters Creek Rd
Roanoke, VA 24019-4021
Phone (703) 562-2110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101-231598VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Mar 1, 2010 Accepting new patients
Carilion Healthcare Corporation CurrentSince May 1, 2017 Accepting new patients
Carilion Medical Center CurrentSince Mar 1, 2010 Accepting new patients
Carilion Healthcare Corporation CurrentSince May 1, 2017 Accepting new patients

Locations

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

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

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

1935 W Main St
Salem, VA 24153
Phone (540) 302-0190

2102 W Main St
Salem, VA 24153
Phone (540) 375-0600

Interoperability endpoints

  • Direct secure messaging: skhawam20370@direct.carilionclinic.org

Organizations & group practices 4

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 5

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1922070945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533109",
            "telephone_number": "540-387-0441",
            "fax_number": "540-389-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAWAM",
        "first_name": "SOUHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101-231598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010099498",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.