Individual provider Active NPI

Ibrahim Nimer Khattab, REGISTERED NURSE

  • Infusion Therapy Registered Nurse
  • El Paso, TX
National Provider Identifier
1265628218
Registry record updated Sep 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
License
615168 Issued in TX
Practice address
7125 Ramada Dr
El Paso, TX 79912-2725
Phone
(915) 587-6218
NPI assigned
Sep 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 615168 TX
Infusion Therapy Registered Nurse 163WI0500X 615168 TX Primary

Addresses

Primary practice location

7125 Ramada Dr
El Paso, TX 79912-2725

Mailing address

7125 Ramada Dr
El Paso, TX 79912-2725
Phone (915) 587-6218

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
615168TXMDInfusion Therapy Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190505600000",
    "number": "1265628218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 RAMADA DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799122725",
            "telephone_number": "915-587-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 RAMADA DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799122725",
            "telephone_number": "915-587-6218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATTAB",
        "first_name": "IBRAHIM",
        "middle_name": "NIMER",
        "name_prefix": "Mr.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-23",
        "last_updated": "2007-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "615168",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "TX",
            "license": "615168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2007; 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.