South Star Care

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

SOUTH STAR CARE

Practice address

3973 Willow Ridge Dr SW
Rochester, MN 55902-2801

Phone

(507) 271-6581

NPI assigned

Oct 9, 2020

Organization subpart

No

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

Authorized official

Name

Nur Abdullahi Mohamed

Title

Owner

Phone

(507) 271-6581

Specialties & licenses 1

Addresses

Other names 1

• Nur Abdullahi Mohamed Former legal business name

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1659979979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 18TH AVE SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559045825",
            "telephone_number": "507-271-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3973 WILLOW RIDGE DR SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022801",
            "telephone_number": "507-271-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH STAR CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "NUR",
        "authorized_official_middle_name": "ABDULLAHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-271-6581"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nur Abdullahi Mohamed",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.