Individual provider Active NPI

Doha Salem

  • Registered Dietitian
  • Columbia Heights, MN
National Provider Identifier
1295232718
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86046832 Issued in MN
Practice address
4000 Central Ave NE
Columbia Heights, MN 55421-2968
Phone
(763) 782-8183
NPI assigned
Apr 11, 2018
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86046832 MN Primary

Addresses

Primary practice location

4000 Central Ave NE
Columbia Heights, MN 55421-2968

Mailing address

18680 97TH PL N # En
Maple Grove, MN 55311-1366

Other identifiers 1

IdentifierTypeStateIssuer
82-3505719MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180827002362 MN Practitioner - Registered Dietitian Or Nutrition Professional 2961751946 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Clinic PAGroup PAC ID 2769384205, 50 clinicians

Practice addresses (Care Compare)

9825 Hospital Dr
Suite 300
Maple Grove, MN 55369-4768
Phone (763) 587-7900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3517MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Dietitian, Registered Current Accepting new patients
Fairview Express Care Current Accepting new patients
North Clinic, PA CurrentSince Jan 5, 2026 Accepting new patients
Fairview Clinics CurrentSince Feb 20, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Jan 12, 2021 Accepting new patients
Fairview Clinics CurrentSince Feb 20, 2021 Accepting new patients
North Clinic, PA CurrentSince Jan 5, 2026 Accepting new patients
Fairview Health Services CurrentSince Aug 31, 2019 Accepting new patients
Fairview Express Care CurrentSince Jan 12, 2021 Accepting new patients
North Memorial Health Care CurrentSince Jan 12, 2021 Accepting new patients
North Memorial Health Care Current Accepting new patients
Fairview Clinics CurrentSince Aug 31, 2019 Accepting new patients

Locations

4181 108th Ave NE
Blaine, MN 55449
Phone (763) 581-0555

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

290 Main St NW
Ste 100
Elk River, MN 55330
Phone (763) 241-0373

9825 Hospital Dr
Ste 300
Maple Grove, MN 55369
Phone (763) 494-7500

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

9201 W Broadway Ave
Ste 601
Minneapolis, MN 55445
Phone (763) 587-7933

50 Central Ave
Osseo, MN 55369
Phone (612) 588-4625

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

2600 39th Ave NE
Saint Anthony, MN 55421
Phone (612) 706-2690

4000 Central Ave NE
Saint Anthony, MN 55421
Phone (763) 572-5700

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1295232718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18680 97TH PL N # EN",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CENTRAL AVE NE",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554212968",
            "telephone_number": "763-782-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEM",
        "first_name": "DOHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "86046832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82-3505719",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.