Individual provider Active NPI

Abdul A Razak, LPN

  • Licensed Practical Nurse
  • Des Moines, IA
National Provider Identifier
1013501550
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
P57023 Issued in IA
Practice address
405 SW 5TH St Ste C
Des Moines, IA 50309-4675
Phone
(515) 771-8545
NPI assigned
Feb 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P57023 IA Primary

Addresses

Primary practice location

405 SW 5TH St Ste C
Des Moines, IA 50309-4675

Mailing address

405 SW 5TH St Ste C
Des Moines, IA 50309-4675
Phone (515) 771-8545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P57023IAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1013501550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 SW 5TH ST STE C",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503094675",
            "telephone_number": "515-771-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SW 5TH ST STE C",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503094675",
            "telephone_number": "515-771-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZAK",
        "first_name": "ABDUL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P57023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.