Organization Active NPI

Ahmed Mohamed MD LLC

  • Psychologist
  • Panama City, FL
National Provider Identifier
1447529086
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
ME81605 Issued in FL
Legal business name
AHMED MOHAMED MD LLC
Practice address
412 W 19TH St
Panama City, FL 32405-4602
Phone
(850) 522-4155
Fax
(850) 522-4156
NPI assigned
Dec 28, 2011
Last updated
Dec 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Authorized official

Name
Ahmed Mohamed, M.D.NPI 1750420626
Title
Medical Doctor
Phone
(850) 522-4155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X ME81605 FL Primary

Addresses

Primary practice location

412 W 19TH St
Panama City, FL 32405-4602

Mailing address

1240 Dundee LN
Lynn Haven, FL 32444-8301
Phone (850) 522-5144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120109000778 FL Part B Supplier - Clinic/Group Practice 6709052004 Receives reassigned benefits from 1 practitioner
Practice locations: Panama City, FL

National Provider Directory

National Provider Directory

Locations

412 W 19th St
Panama City, FL 32405
Phone (850) 522-4155

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1447529086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 DUNDEE LN",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324448301",
            "telephone_number": "850-522-5144",
            "fax_number": "850-522-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054602",
            "telephone_number": "850-522-4155",
            "fax_number": "850-522-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHMED MOHAMED MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "850-522-4155",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "ME81605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.