Individual provider Active NPI

Abdisamad Said Mohamud

  • Transportation Network Company
  • Green Bay, WI
National Provider Identifier
1396618013
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transportation Network CompanyTaxonomy code 342000000X
Practice address
704 S Oakland Ave Lowr
Green Bay, WI 54304-2615
Phone
(920) 489-4821
NPI assigned
Sep 29, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Network Company 342000000X WI Primary

Addresses

Primary practice location

704 S Oakland Ave Lowr
Green Bay, WI 54304-2615

Mailing address

704 S Oakland Ave Lowr
Green Bay, WI 54304-2615
Phone (920) 489-4821

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": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1396618013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 S OAKLAND AVE LOWR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042615",
            "telephone_number": "920-489-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S OAKLAND AVE LOWR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042615",
            "telephone_number": "920-489-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMUD",
        "first_name": "ABDISAMAD",
        "middle_name": "SAID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.