Khadijah Oluwatoyin Ibrahim, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1116351 Issued in TX

Practice address

12221 Merit Dr Ste 450
Dallas, TX 75251-2294

Phone

(972) 770-1032

NPI assigned

Jun 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Psychiatric Medicine PLLCGroup PAC ID 2860560059, 8 clinicians

Jbutlermdphd PLLCGroup PAC ID 4880006691, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khadijah.ibrahim@hca7.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emergency Psychiatric Medicine, PLLC

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1558538520
  Medicare reassignment Care Compare group NPD
• Jbutlermdphd PLLC

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1942831110
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1134805666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 TURKS CAP TRL",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984626",
            "telephone_number": "713-882-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 MERIT DR STE 450",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512294",
            "telephone_number": "972-770-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "KHADIJAH",
        "middle_name": "OLUWATOYIN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1116351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antony Ibrahim, MD
• Hassan Nimer Ibrahim, M.B., B.S.
• Hicham Mohsen Ibrahim, M.D.
• Ibrahim Fuad Ibrahim, M.D.
• Kalid A Ibrahim, PHARMD.
• Mostafa A Ibrahim
• Sarah M Ibrahim, PA-C
• Stephanie Adel Ibrahim, MD
• Jon Iburg
• Ibyah Anesthesia PLLC

• Psychiatric/Mental Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.