Individual provider Active NPI

Hibo Ahmed, PNP-C

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1245880723
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
10797 Issued in MN
Practice address
2301 Central Ave NE
Minneapolis, MN 55418-3709
Phone
(612) 588-9411
NPI assigned
Sep 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 10797 MN Primary

Addresses

Primary practice location

2301 Central Ave NE
Minneapolis, MN 55418-3709

Mailing address

2226 119TH Ave NE
Blaine, MN 55449-5440
Phone (612) 735-8097

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
10797MNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthsource PastSince Nov 1, 2009 Accepting new patients
Neighborhood Healthsource Past Accepting new patients

Organizations & group practices 2

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": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1245880723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 119TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495440",
            "telephone_number": "612-735-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CENTRAL AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183709",
            "telephone_number": "612-588-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "HIBO",
        "credential": "PNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "10797",
            "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 11, 2024; 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.