Active NPI
Nour Ibrahim, MD
- Geriatric Medicine (Internal Medicine) Physician
- Saint Louis, MO
National Provider Identifier
1336029032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 2025015467
- Practice address
- 1201 S Grand Blvd
Saint Louis, MO 63104-1016 - Phone
- (314) 257-8000
- NPI assigned
- Sep 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 2025015467 | MO | Primary |
Addresses
Primary practice location
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Mailing address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251103001373 | MO | Order and Referring Only - Geriatric Medicine | 1153810726 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025015467 | MO | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774828800000",
"number": "1336029032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041016",
"telephone_number": "314-257-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "NOUR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-03",
"last_updated": "2026-03-30",
"certification_date": "2026-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "MO",
"license": "2025015467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.