Individual provider Active NPI

Mohamed Aden Geire

  • Home Health Agency
  • Eden Prairie, MN
National Provider Identifier
1114529096
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
396382 Issued in MN
Practice address
12570 Crowfoot CT
Eden Prairie, MN 55344-3937
Phone
(952) 290-6029
NPI assigned
Nov 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 396382 MN Primary

Addresses

Primary practice location

12570 Crowfoot CT
Eden Prairie, MN 55344-3937

Mailing address

12570 Crowfoot CT
Eden Prairie, MN 55344-3937
Phone (952) 290-6029

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
396382MNMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1605398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1114529096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12570 CROWFOOT CT",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443937",
            "telephone_number": "952-290-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12570 CROWFOOT CT",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443937",
            "telephone_number": "952-290-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEIRE",
        "first_name": "MOHAMED",
        "middle_name": "ADEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-15",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "396382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; 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.