Kamal G Abulsaad, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

702 Issued in NC

Practice address

410 New Bridge St
Sute 9-B
Jacksonville, NC 28540-4739

Phone

(910) 455-4727

Fax

(910) 455-7676

NPI assigned

May 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Other names 1

• Dr. Kim G Abulsaad Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710930631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 NEW BRIDGE ST",
            "address_2": "SUTE 9-B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404739",
            "telephone_number": "910-455-4727",
            "fax_number": "910-455-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NEW BRIDGE ST",
            "address_2": "SUTE 9-B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404739",
            "telephone_number": "910-455-4727",
            "fax_number": "910-455-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABULSAAD",
        "first_name": "KAMAL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000023",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "ABULSAAD",
            "middle_name": "G",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Psychologist in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.