Organization Active NPI

Ultimate Supportive Services LLC

  • Nursing Care Agency
  • Minneapolis, MN
National Provider Identifier
1245030378
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
ULTIMATE SUPPORTIVE SERVICES LLC
Practice address
1801 2ND Ave S Apt 27
Minneapolis, MN 55403-3912
Phone
(614) 462-9556
NPI assigned
Mar 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Mohammed Ibrahim
Title
Owner/Ceo
Phone
(614) 462-9556

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Nursing Care Agency 251J00000X Primary

Addresses

Primary practice location

1801 2ND Ave S Apt 27
Minneapolis, MN 55403-3912

Mailing address

1801 2ND Ave S Apt 27
Minneapolis, MN 55403-3912
Phone (614) 462-9556

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1245030378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 2ND AVE S APT 27",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033912",
            "telephone_number": "614-462-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 2ND AVE S APT 27",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033912",
            "telephone_number": "614-462-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE SUPPORTIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "614-462-9556"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.