Individual provider Active NPI

Salim Abdul-Haqq, LPN

  • Licensed Practical Nurse
  • Raleigh, NC
National Provider Identifier
1235326752
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
68700 Issued in NC
Practice address
4622 Wedgewood Dr
Raleigh, NC 27604-4998
Phone
(919) 931-1029
Fax
(919) 792-0879
NPI assigned
Sep 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 68700 NC Primary

Addresses

Primary practice location

4622 Wedgewood Dr
Raleigh, NC 27604-4998

Mailing address

4622 Wedgewood Dr
Raleigh, NC 27604-4998
Phone (919) 931-1029

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Raleigh

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
68700NCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1235326752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 WEDGEWOOD DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276044998",
            "telephone_number": "919-931-1029",
            "fax_number": "919-792-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 WEDGEWOOD DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276044998",
            "telephone_number": "919-931-1029",
            "fax_number": "919-792-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDUL-HAQQ",
        "first_name": "SALIM",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "68700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Raleigh",
            "affiliation": "N",
            "address_1": "4622 Wedgewood Dr",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276044998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 31, 2023; 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.