Active NPI
Abdiwahid Adam
- Driver
- New Brighton, MN
National Provider Identifier
1679356463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- F216072066209
- Practice address
- 617 8TH Ave NW Unit 334
New Brighton, MN 55112-4149 - Phone
- (612) 220-0365
- NPI assigned
- Aug 15, 2023
- Last updated
- Aug 15, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | F216072066209 | NU | Primary |
Addresses
Primary practice location
617 8TH Ave NW Unit 334
New Brighton, MN 55112-4149
Mailing address
617 8TH Ave NW Unit 334
New Brighton, MN 55112-4149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Priority Health Center | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Early Intervention Provider Agency
- St Anthony, MN
- NPI 1912606930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1679356463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 8TH AVE NW UNIT 334",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551124149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 8TH AVE NW UNIT 334",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551124149",
"telephone_number": "612-220-0365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAM",
"first_name": "ABDIWAHID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-15",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "NU",
"license": "F216072066209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Brighton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.