Individual provider Active NPI

Iana Ibrahim, L.AC.

  • Acupuncturist
  • Bel Air, MD
National Provider Identifier
1295352862
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
U02749 Issued in MD
Practice address
260 Gateway Dr Ste 11-12a
Bel Air, MD 21014-4268
Phone
(410) 900-2227
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X U02749 MD Primary

Addresses

Primary practice location

260 Gateway Dr Ste 11-12a
Bel Air, MD 21014-4268

Mailing address

251 W Early Ave
Coaldale, PA 18218-1129
Phone (646) 239-0029

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
U02749MDMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Acupuncture LLC Acupuncturist CurrentSince Aug 16, 2020 Accepting new patients

Locations

260 Gateway Dr
Ste 1112A
Bel Air, MD 21014
Phone (410) 870-9388

Organizations & group practices 1

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": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1295352862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 W EARLY AVE",
            "city": "COALDALE",
            "state": "PA",
            "postal_code": "182181129",
            "telephone_number": "646-239-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 GATEWAY DR STE 11-12A",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144268",
            "telephone_number": "410-900-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "IANA",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U02749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.