Individual provider Active NPI

Ballah A Kabbah

  • Contractor
  • Philadelphia, PA
National Provider Identifier
1386044485
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
6418 Elmwood Ave
Philadelphia, PA 19142-3110
Phone
(267) 701-3341
NPI assigned
Aug 26, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

6418 Elmwood Ave
Philadelphia, PA 19142-3110

Mailing address

6418 Elmwood Ave
Philadelphia, PA 19142-3110
Phone (267) 701-3341

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

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1386044485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 ELMWOOD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191423110",
            "telephone_number": "267-701-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 ELMWOOD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191423110",
            "telephone_number": "267-701-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABBAH",
        "first_name": "BALLAH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.