Active NPI
Mohamed I Ibrahim, RPH, CSP
- Pharmacist
- Sioux Falls, SD
National Provider Identifier
1447675574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6130
- Practice address
- 4901 N 4TH Ave
Sioux Falls, SD 57104-0444 - Phone
- (800) 835-3784
- Fax
- (800) 973-7150
- NPI assigned
- Feb 26, 2014
- Last updated
- Feb 3, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63430 | TX | |
| Pharmacist | 183500000X | 6130 | SD | Primary |
Addresses
Primary practice location
4901 N 4TH Ave
Sioux Falls, SD 57104-0444
Mailing address
4901 N 4TH Ave
Sioux Falls, SD 57104-0444
Phone (800) 835-3784
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6130 | SD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tel-Drug Inc | Past | Accepting new patients | |
| Tel-Drug of Pennsylvania, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Cigna Home Delivery Pharmacy
- Mail Order Pharmacy
- Horsham, PA
- NPI 1487657839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580688000000",
"number": "1447675574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4901 N 4TH AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571040444",
"telephone_number": "800-835-3784",
"fax_number": "800-973-7150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 N 4TH AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571040444",
"telephone_number": "800-835-3784",
"fax_number": "800-973-7150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "MOHAMED",
"middle_name": "I",
"credential": "RPH, CSP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-26",
"last_updated": "2020-02-03",
"certification_date": "2020-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "63430",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "6130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.