Active NPI
Fowsia S Isse
- Health Maintenance Organization
- Minneapolis, MN
National Provider Identifier
1407219645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- Practice address
- 5519 Lyndale Ave N
Minneapolis, MN 55430-3216 - Phone
- (612) 978-7470
- NPI assigned
- Apr 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Health Maintenance Organization | 302R00000X | Primary |
Addresses
Primary practice location
5519 Lyndale Ave N
Minneapolis, MN 55430-3216
Mailing address
324 Jolly LN NE
Minneapolis, MN 55421-5049
Phone (612) 978-7470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Other | MN | ADULT FOSTER CARE |
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": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459728000000",
"number": "1407219645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 JOLLY LN NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554215049",
"telephone_number": "612-978-7470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5519 LYNDALE AVE N",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554303216",
"telephone_number": "612-978-7470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISSE",
"first_name": "FOWSIA",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-04",
"last_updated": "2016-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADULT FOSTER CARE",
"identifier": "PENDING",
"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 Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.