Individual provider Active NPI

Mahmoud N Al-Hawamdeh, MD

  • Internal Medicine Physician
  • Kennewick, WA
National Provider Identifier
1467405340
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00037902 Issued in WA
Practice address
320 W 10TH Ave
Suite 202
Kennewick, WA 99336-6302
Phone
(509) 586-5113
Fax
(509) 586-5143
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00037902 WA Primary

Addresses

Primary practice location

320 W 10TH Ave
Suite 202
Kennewick, WA 99336-6302

Mailing address

7203 W Deschutes Ave
Kennewick, WA 99336-7777
Phone (509) 737-1880

Other identifiers 1

IdentifierTypeStateIssuer
8249492MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00037902WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ling Medical Associates Internal Medicine Past Accepting new patients
Kennewick Public Hospital District Past Accepting new patients
Tri Cities OB and GYN PC Past Accepting new patients
Kennewick Public Hospital District Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1467405340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7203 W DESCHUTES AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367777",
            "telephone_number": "509-737-1880",
            "fax_number": "509-737-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W 10TH AVE",
            "address_2": "SUITE 202",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366302",
            "telephone_number": "509-586-5113",
            "fax_number": "509-586-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-HAWAMDEH",
        "first_name": "MAHMOUD",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00037902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8249492",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.