Active NPI
Sumeya Hamza Abdulrahman I
- Behavior Technician
- Minneapolis, MN
National Provider Identifier
1437802311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- J650172588111
- Practice address
- 618 9TH Ave S Apt 409
Minneapolis, MN 55415-5541 - Phone
- (763) 528-5609
- NPI assigned
- Jan 31, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | J650172588111 | MN | |
| Behavior Technician | 106S00000X | J650172588111 | MN | Primary |
Addresses
Primary practice location
618 9TH Ave S Apt 409
Minneapolis, MN 55415-5541
Mailing address
618 9TH Ave S Apt 409
Minneapolis, MN 55415-4611
Phone (763) 528-5609
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4565500255 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | fraser | Health Information Exchange (HIE) |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J650172588111 | MN | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643587200000",
"number": "1437802311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "618 9TH AVE S APT 409",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554154611",
"telephone_number": "763-528-5609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 9TH AVE S APT 409",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554155541",
"telephone_number": "763-528-5609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDULRAHMAN",
"first_name": "SUMEYA",
"middle_name": "HAMZA",
"name_prefix": "Miss",
"name_suffix": "I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-31",
"last_updated": "2022-01-31",
"certification_date": "2022-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MN",
"license": "J650172588111",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MN",
"license": "J650172588111",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4565500255",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "fraser",
"affiliation": "N",
"endpointDescription": "homecare",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "618 9th Ave S Apt 409",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "55415",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.