Wallingburg Home Care Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

26340582 Issued in MN

Legal business name

WALLINGBURG HOME CARE SERVICES

Practice address

2630 University Ave SE Ste A158
Minneapolis, MN 55414-3264

Phone

(612) 978-1821

Fax

(612) 354-2310

NPI assigned

Jan 8, 2015

Organization subpart

No

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

Authorized official

Name

Abdul Abdishakur

Title

Ceo

Phone

(612) 978-1821

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1639567977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 UNIVERSITY AVE SE STE A158",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143264",
            "telephone_number": "612-978-1821",
            "fax_number": "612-354-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 UNIVERSITY AVE SE STE A158",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143264",
            "telephone_number": "612-978-1821",
            "fax_number": "612-354-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLINGBURG HOME CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "ABDISHAKUR",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-978-1821"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "26340582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A504140000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas K Wallace, CRNA
• Willie Wallace
• Jeff Wallager
• Nancy Waller, M.D.
• Jason Owen Wallin, DC
• Elizabeth Joan Wallner, PT
• Caitlin Maurine Walseth
• David Alan Walsh, PH.D.
• Jocelyn Walsh, CCC-SLP, M.ED.
• Karisa Lynn Walsh, DC

• Home Health Agency in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.