Fatma Mohamed Ibrahim Shabana

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2025013533 Issued in MO

Practice address

13013 Fuller Ave Ste a
Grandview, MO 64030-2687

Phone

(816) 214-5548

NPI assigned

Jun 4, 2025

Last updated

Jun 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Medina Clinic, Incorporated

  dba The Medina Clinic

  • Primary Care Clinic/Center
  • Grandview, MO
  • NPI 1073893046
  NPD (past)

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1396639340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 E BROADWAY APT 1E",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015874",
            "telephone_number": "573-268-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13013 FULLER AVE STE A",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640302687",
            "telephone_number": "816-214-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABANA",
        "first_name": "FATMA",
        "middle_name": "MOHAMED IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2025013533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selectra Onesource, Inc. (Selectra Health Adult Day Care)
• Tamara Semrick
• Senior and Veteran Adult Day Services LLC
• Serc Rehabilitation Partners LLC
• Allie Seymour, MOT
• Hina Siddiqi
• William Robert Simons III, PT, DPT
• Vanisha Simpson
• Gurjeet Singh, MD
• Colin Tollerton Smith Jr., D.D.S

• Internal Medicine Physician in Grandview, MO
• Providers in Grandview, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.