Yagoub Abubaker Yagoub Ibrahim, M.B.B.S.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1465 South Grand Boulevard
2ND Floor Glennon Hall Room 2717
St. Louis, MO 63104-1003

Phone

(314) 577-5634

Fax

(314) 577-5616

NPI assigned

May 16, 2025

Reactivated

Jul 2, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1619768777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 SOUTH GRAND BOULEVARD",
            "address_2": "2ND FLOOR GLENNON HALL ROOM 2717",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5634",
            "fax_number": "314-577-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 SOUTH GRAND BOULEVARD",
            "address_2": "2ND FLOOR GLENNON HALL ROOM 2717",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5634",
            "fax_number": "314-577-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGOUB IBRAHIM",
        "first_name": "YAGOUB ABUBAKER",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-16",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "deactivation_date": "2026-03-16",
        "reactivation_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravi Yadava, D.O.
• Shivi Yadava, DO
• Garrett Michael Yadro, CRNA
• Michelle Yager, PHARM.D
• Missy K Yager, DPT
• Alexander Thomas Yahanda, MD
• Gretchen Yahnke, LCSW
• Yahweh Way Healthcare LLC
• Emily Christine Yakel, DPT
• Richard Yakimo, APRN, PMHNP-BC

• Student in an Organized Health Care Education/Training Program in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Student in an Organized Health Care Education/Training Program in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.