Active NPI
Yaqutullah Ibraheem, MS, RD, LD
- Registered Dietitian
- Atlanta, GA
National Provider Identifier
1346472834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 003181
- Practice address
- 4071 Codel St SW
Atlanta, GA 30331-4355 - Phone
- (404) 454-7356
- NPI assigned
- Aug 17, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 003181 | GA | Primary |
Addresses
Primary practice location
4071 Codel St SW
Atlanta, GA 30331-4355
Mailing address
2670 Miriam LN
Decatur, GA 30032-5731
Phone (404) 454-7356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346472834 | Other | GA | NPI |
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)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Prescriptions LLC | Dietitian, Registered | Current | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
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": "1250467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545177600000",
"number": "1346472834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2670 MIRIAM LN",
"city": "DECATUR",
"state": "GA",
"postal_code": "300325731",
"telephone_number": "404-454-7356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4071 CODEL ST SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303314355",
"telephone_number": "404-454-7356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHEEM",
"first_name": "YAQUTULLAH",
"name_prefix": "Ms.",
"credential": "MS, RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-17",
"last_updated": "2018-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "003181",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1346472834",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.