Tark Ahmed Abou-Elmagd

Primary specialty

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

Practice address

1638 Owen Drive Fayetteville, NC 28302
Fayetteville, NC 28304

Phone

(910) 615-3960

Fax

(910) 615-9907

NPI assigned

Apr 11, 2023

Sex

Male

Sole proprietor

Yes

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

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1649966979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DRIVE FAYETTEVILLE, NC 28302",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-615-3960",
            "fax_number": "910-615-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DRIVE FAYETTEVILLE, NC 28302",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-615-3960",
            "fax_number": "910-615-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOU-ELMAGD",
        "first_name": "TARK",
        "middle_name": "AHMED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-01",
        "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": []
}

• Able Care Home Health, Inc
• Able Pharmaceutical Services
• Kallynn Lee Abner
• Moses Y Aboagye-Kumi, M.D.
• Patricia Aboagye-Kumi, PA-C
• Scarlett Abounada, LCSWA
• Abounding Grace Family Care Home, Incorporated
• Above All Home Care Agency LLC
• Kimberly Abraham, TRICHOLOGIST
• Abigail Abrahamson, LMBT

• All providers in Fayetteville, NC
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.