Active NPI
Abdoulaye Soumahoro
- Driver
- Pawtucket, RI
National Provider Identifier
1235600255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 2310551
- Practice address
- 68 Webster St
Pawtucket, RI 02861-1016 - Phone
- (401) 359-0720
- Fax
- (401) 495-4022
- NPI assigned
- Dec 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Driver | 172A00000X | 2310551 | RI | Primary |
Addresses
Primary practice location
68 Webster St
Pawtucket, RI 02861-1016
Mailing address
68 Webster St
Pawtucket, RI 02861-1016
Phone (401) 359-0720
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2310551 | Medicaid | RI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2310551 | RI | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545004800000",
"number": "1235600255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 WEBSTER ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028611016",
"telephone_number": "401-359-0720",
"fax_number": "401-495-4022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 WEBSTER ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028611016",
"telephone_number": "401-359-0720",
"fax_number": "401-495-4022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUMAHORO",
"first_name": "ABDOULAYE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-17",
"last_updated": "2018-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "RI",
"license": "2310551",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2310551",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.