DR. KASEM GHANNAM D.O.
NPI 1417680067
Emergency Medicine in Jackson, TN
About Dr. Kasem Ghannam D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KASEM GHANNAM D.O. (NPI 1417680067) is an individual emergency medicine provider in Jackson, Tennessee, licensed in Tennessee (6303) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS, is affiliated with Jackson-madison County General Hospital, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Kasem Ghannam D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kasem Ghannam reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jackson, TN 38301
- Reassigned Medicare billing, Tennessee enrollment
- 146 clinicians in this Medicare group
Jackson, TN 38301
- Reassigned Medicare billing, Tennessee enrollment
- 50 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Jackson-Madison County General Hospital
Acute Care Hospitals · Jackson, TNWest Tennessee Healthcare Milan Hospital
Acute Care Hospitals · Milan, TNVolunteer Community Hospital
Acute Care Hospitals · Martin, TNWest Tennessee Healthcare Bolivar Hospital
Critical Access Hospitals · Bolivar, TNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 38301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSON, TN 38301
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kasem Ghannam's NPI number?
The NPI number for Kasem Ghannam is 1417680067. It was assigned to this individual provider in the NPPES registry on July 1, 2022.
Where is Kasem Ghannam located?
Kasem Ghannam practices at 620 Skyline Dr, Jackson, TN 38301. The listed phone number is (731) 541-0000.
What is Kasem Ghannam's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Kasem Ghannam enrolled in Medicare?
Yes. Kasem Ghannam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kasem Ghannam's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kasem Ghannam reassigns Medicare benefits to 2 organizations: Emergency Medical Care Facilities PC (Jackson, TN) and Wt University Medical Associates Inc (Jackson, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kasem Ghannam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kasem Ghannam affiliated with any hospitals?
According to CMS data, Kasem Ghannam is affiliated with Jackson-Madison County General Hospital, West Tennessee Healthcare Milan Hospital, Volunteer Community Hospital and West Tennessee Healthcare Bolivar Hospital.
When was this NPI record last updated?
The NPPES record for Kasem Ghannam was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Kasem Ghannam, D.O. · NPI 1417680067
Emergency Medicine physician in Jackson, Tennessee. Individual provider, active in the CMS NPPES registry since July 1, 2022.
## Identity
- **NPI:** 1417680067 (Entity type: Individual)
- **Enumerated:** July 1, 2022
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 6303 (Tennessee)
- **Sole proprietor:** No
## Practice location
- **Address:** 620 SKYLINE DR, Jackson, TN 38301-3923
- **Phone:** (731) 541-0000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Emergency Medical Care Facilities PC (NPI 1538345855, Jackson, TN); Wt University Medical Associates Inc (NPI 1023572344, Jackson, TN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** July 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1417680067) · Data from the CMS NPPES public registry.