NPIMap

Individual provider Active NPI

Hamid Koi Ibrahim, DC

  • Rehabilitation Chiropractor
  • Pembroke Pines, FL
National Provider Identifier
1356733737
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CH 11340 Issued in FL
Practice address
10796 Pines Blvd Ste 101
Pembroke Pines, FL 33026-3919
Phone
(954) 367-4888
Fax
(954) 367-4889
NPI assigned
Feb 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CH 11340 FL Primary

Addresses

Primary practice location

10796 Pines Blvd Ste 101
Pembroke Pines, FL 33026-3919

Mailing address

10796 Pines Blvd Ste 101
Pembroke Pines, FL 33026-3919
Phone (954) 367-4888

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

State licenses

LicenseStateTypeSpecialty
CH 11340FLMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Rhea Conley, LLC PastSince Oct 7, 2015 Accepting new patients
Fidel S. Goldson, DC PA Past Accepting new patients

Organizations & group practices 2

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": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1356733737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10796 PINES BLVD STE 101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263919",
            "telephone_number": "954-367-4888",
            "fax_number": "954-367-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10796 PINES BLVD STE 101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263919",
            "telephone_number": "954-367-4888",
            "fax_number": "954-367-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "HAMID",
        "middle_name": "KOI",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH 11340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.