Individual provider Active NPI

Barbara Ann Ibrahim, RN

  • Registered Nurse
  • Warmsprings, OR
National Provider Identifier
1104050970
Registry record updated May 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
088000415 RN Issued in OR
Practice address
1270 Kotnum Road
Warmsprings, OR 97761-1209
Phone
(541) 553-1196
Fax
(541) 553-2135
NPI assigned
May 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 088000415 RN OR Primary

Addresses

Primary practice location

1270 Kotnum Road
Warmsprings, OR 97761-1209

Mailing address

PO Box 1209
Warm Springs, OR 97761-1209
Phone (541) 553-3070

Other identifiers 1

IdentifierTypeStateIssuer
HSZ204OtherMEDICARE GROUP NUMBER

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
088000415 RNORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1104050970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "977611209",
            "telephone_number": "541-553-3070",
            "fax_number": "541-553-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 KOTNUM ROAD",
            "city": "WARMSPRINGS",
            "state": "OR",
            "postal_code": "977611209",
            "telephone_number": "541-553-1196",
            "fax_number": "541-553-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "BARBARA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "088000415 RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "HSZ204",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warmsprings, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; 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.