Individual provider Active NPI

Farxiyo Abdi M Bashir, N/A

  • Behavior Technician
  • Burnsville, MN
National Provider Identifier
1295427367
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
106S00000X Issued in MN
Practice address
11972 Portland Ave
Burnsville, MN 55337-1516
Phone
(952) 228-8572
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 106S00000X MN Primary

Addresses

Primary practice location

11972 Portland Ave
Burnsville, MN 55337-1516

Mailing address

8649 Columbine Rd # 8649
Eden Prairie, MN 55344-7668
Phone (612) 442-0611

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
106S00000XMNMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1295427367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8649 COLUMBINE RD # 8649",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447668",
            "telephone_number": "612-442-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11972 PORTLAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371516",
            "telephone_number": "952-228-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHIR",
        "first_name": "FARXIYO",
        "middle_name": "ABDI M",
        "credential": "N/A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": "106S00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.