Individual provider Active NPI

Saida Mohamed, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Minneapolis, MN
National Provider Identifier
1366689002
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
119211 Issued in MN
Practice address
1822 E Lake St
Minneapolis, MN 55407-1879
Phone
(612) 987-2002
NPI assigned
Jan 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 119211 MN Primary

Addresses

Primary practice location

1822 E Lake St
Minneapolis, MN 55407-1879

Mailing address

590 Sutherland Dr
Woodbury, MN 55129-8543

Other identifiers 1

IdentifierTypeStateIssuer
119211OtherMNBOARD OF PHARMACY

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
119211MNMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cedar Pharmacy Current Accepting new patients

Organizations & group practices 1

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1366689002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 SUTHERLAND DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551298543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 E LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071879",
            "telephone_number": "612-987-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "SAIDA",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "119211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "119211",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.