Atif Ibrahim

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

830 S Gloster St
Tupelo, MS 38801-4996

Phone

(662) 377-3000

NPI assigned

Jul 9, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: atifibrahim@nmhs.medalliesdirect.net

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.

• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1336767938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTH MISSISSIPPI MEDICAL CENTER",
            "address_2": "830 S GLOSTER ST,",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014996",
            "telephone_number": "662-377-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014996",
            "telephone_number": "662-377-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "ATIF",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-09",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyla Hutchens
• Cynthia Hutcheson
• Jonathan Huwe, PHARMD
• Susan Patrice Hyatt, PH.D.
• Patricia Ross Hych, MA
• Omer Mohamed Ali Ibrahim, BDS, DDS
• Wanda Ikeda, ACNP
• Illuminated Life Counseling LLC
• Imaging Center at Gloster Creek Village PLLC
• Abrahim Imam

• Student in an Organized Health Care Education/Training Program in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Student in an Organized Health Care Education/Training Program in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.

Verify at the official NPI Registry.