NPIMap

Organization Active NPI

Khadra M Osman M D P a

  • Medical Specialty Clinic/Center
  • Fort Lauderdale, FL
National Provider Identifier
1467422097
Registry record updated Aug 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
ME0060084 Issued in FL
Legal business name
KHADRA M OSMAN M D P A
Practice address
1625 SE 3Rd Ave
Suite 400
Fort Lauderdale, FL 33316-2521
Phone
(954) 832-0055
Fax
(954) 832-0262
NPI assigned
Jan 25, 2006
Last updated
Aug 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2010

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

Authorized official

Name
Dr. Khadra Mohamoud Osman, M.D.NPI 1952460669
Title
President
Phone
(954) 832-0055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X ME0060084 FL Primary

Addresses

Primary practice location

1625 SE 3Rd Ave
Suite 400
Fort Lauderdale, FL 33316-2521

Mailing address

1625 SE 3Rd Ave
400
Fort Lauderdale, FL 33316-2521
Phone (954) 832-0055

Other identifiers 1

IdentifierTypeStateIssuer
370049600MedicaidFL

National Provider Directory

National Provider Directory

Locations

1625 SE 3rd Ave
#400
Fort Lauderdale, FL 33316
Phone (954) 832-0055

1625 SE 3rd Ave
Ste 400
Ft Lauderdale, FL 33316
Phone (954) 832-0055

Practitioners & affiliated clinicians

Practitioners 11

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": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283040000000",
    "number": "1467422097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SE 3RD AVE",
            "address_2": "400",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162521",
            "telephone_number": "954-832-0055",
            "fax_number": "954-832-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SE 3RD AVE",
            "address_2": "SUITE 400",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162521",
            "telephone_number": "954-832-0055",
            "fax_number": "954-832-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHADRA M OSMAN M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2010-08-29",
        "status": "A",
        "authorized_official_last_name": "OSMAN",
        "authorized_official_first_name": "KHADRA",
        "authorized_official_middle_name": "MOHAMOUD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-832-0055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME0060084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370049600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.