Individual provider Active NPI

Faduma Abdullahi Addow

  • General Practice Physician
  • Saint Paul, MN
National Provider Identifier
1154052173
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0-657-594-8 Issued in CA
Practice address
1821 University Ave W Ste 181
Saint Paul, MN 55104-2879
Phone
(161) 225-9771
Fax
(612) 259-7889
NPI assigned
Jun 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0-657-594-8 CA Primary

Addresses

Primary practice location

1821 University Ave W Ste 181
Saint Paul, MN 55104-2879

Mailing address

1821 University Ave W Ste 181
Saint Paul, MN 55104-2879
Phone (161) 225-9771

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
0-657-594-8CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Senzilla Transportation, Inc. CurrentSince Dec 10, 2023 Accepting new patients

Locations

1821 University Ave W
Ste 181
Saint Paul, MN 55104
Phone (612) 259-7715

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1154052173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 181",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042879",
            "telephone_number": "161-225-9771",
            "fax_number": "612-259-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 181",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042879",
            "telephone_number": "161-225-9771",
            "fax_number": "612-259-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDOW",
        "first_name": "FADUMA",
        "middle_name": "ABDULLAHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "0-657-594-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.