Active NPI
Sherine Ibrahim, M.D.
- Pediatrics Physician
- Raleigh, NC
National Provider Identifier
1225003056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 26790
- Practice address
- 4016 Barrett Dr
Suite 101
Raleigh, NC 27609-6623 - Phone
- (919) 787-5437
- Fax
- (919) 781-6328
- NPI assigned
- Feb 23, 2006
- Last updated
- Oct 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 26790 | NC | Primary |
Addresses
Primary practice location
4016 Barrett Dr
Suite 101
Raleigh, NC 27609-6623
Mailing address
4016 Barrett Dr
Suite 101
Raleigh, NC 27609-6623
Phone (919) 787-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7945199 | Medicaid | NC |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26790 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Essex Pediatrics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Medical Specialty Clinic/Center
- Raleigh, NC
- NPI 1619920048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1225003056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4016 BARRETT DR",
"address_2": "SUITE 101",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096623",
"telephone_number": "919-787-5437",
"fax_number": "919-781-6328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4016 BARRETT DR",
"address_2": "SUITE 101",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096623",
"telephone_number": "919-787-5437",
"fax_number": "919-781-6328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "SHERINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "26790",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7945199",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.