Active NPI
Sameena Ahmed, MD
- Anatomic Pathology & Clinical Pathology Physician
- Moline, IL
National Provider Identifier
1073592333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 036063289
- Practice address
- 1520 7TH Street
Moline, IL 61265 - Phone
- (309) 762-8555
- Fax
- (563) 324-2948
- NPI assigned
- Jan 13, 2006
- Last updated
- Aug 5, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 036063289 | IL | Primary |
Addresses
Primary practice location
1520 7TH Street
Moline, IL 61265
Mailing address
1814 E Locust St
Davenport, IA 52803
Phone (563) 324-0471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036063289 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1073592333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1814 E LOCUST ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "52803",
"telephone_number": "563-324-0471",
"fax_number": "563-324-2948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 7TH STREET",
"city": "MOLINE",
"state": "IL",
"postal_code": "61265",
"telephone_number": "309-762-8555",
"fax_number": "563-324-2948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMED",
"first_name": "SAMEENA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-13",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IL",
"license": "036063289",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036063289",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.