Kassim Mohamed

Primary specialty

TechnicianTaxonomy code 374700000X

License

1084488 Issued in MN

Practice address

860 Blue Gentian Rd
Ste 200
Saint Paul, MN 55121-1564

Phone

(952) 737-2965

NPI assigned

Mar 16, 2017

Last updated

Mar 16, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1467993956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 BLUE GENTIAN RD",
            "address_2": "STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551211564",
            "telephone_number": "952-737-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 BLUE GENTIAN RD",
            "address_2": "STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551211564",
            "telephone_number": "952-737-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "KASSIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "MN",
            "license": "1084488",
            "primary": true
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MN",
            "license": "1084488",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": "1084488",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idil Ahmed Mohamed
• Idil Nuur Mohamed
• Ikram Mohamed
• Ishwaq Yusuf Mohamed
• Jimale Abdi Mohamed
• Katra Mohamed
• Khadija Mohamed
• Khadra Mohamed
• Kiin Hussein Mohamed, RN
• Kiman Abdi Mohamed

• Technician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.