Individual provider Active NPI

Fadi Ibrahim, MD

  • Family Medicine Physician
  • Montgomery, AL
National Provider Identifier
1548033418
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME179834 Issued in FL
Practice address
4371 Narrow Lane Rd Ste 100
Montgomery, AL 36116-2975
Phone
(334) 747-3680
Fax
(334) 747-7880
NPI assigned
Nov 2, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME179834 FL Primary

Addresses

Primary practice location

4371 Narrow Lane Rd Ste 100
Montgomery, AL 36116-2975

Mailing address

4371 Narrow Lane Rd Ste 100
Montgomery, AL 36116-2975
Phone (334) 747-3680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260626000277 FL Practitioner - Family Practice 7113490558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

770 W Granada Blvd
Suite 101
Ormond Beach, FL 32174-5179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L.6144RALMDStudent in an Organized Health Care Education/Training Program

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1548033418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 NARROW LANE RD STE 100",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162975",
            "telephone_number": "334-747-3680",
            "fax_number": "334-747-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 NARROW LANE RD STE 100",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162975",
            "telephone_number": "334-747-3680",
            "fax_number": "334-747-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "FADI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-02",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME179834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.