Individual provider Active NPI

Abdulsalam Alkadhy

  • Student in an Organized Health Care Education/Training Program
  • Pontiac, MI
National Provider Identifier
1154918282
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
5351016498 Issued in MI
Practice address
687 University Dr
Pontiac, MI 48342-1758
Phone
(313) 888-2212
NPI assigned
Dec 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5351016498 MI Primary

Addresses

Primary practice location

687 University Dr
Pontiac, MI 48342-1758

Mailing address

1529 Ferney St # 1
Dearborn, MI 48120-1711
Phone (313) 888-2212

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
5351016498MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Medical Pharmacy CurrentSince Dec 27, 2020 Accepting new patients

Locations

687 University Dr
Pontiac, MI 48342
Phone (313) 888-2212

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": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1154918282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 FERNEY ST # 1",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201711",
            "telephone_number": "313-888-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 UNIVERSITY DR",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421758",
            "telephone_number": "313-888-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALKADHY",
        "first_name": "ABDULSALAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5351016498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

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