Individual provider Active NPI

Ali Mohamed Ahmed

  • Community Health Worker
  • Minneapolis, MN
National Provider Identifier
1740005644
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
1496192700023 Issued in MN
Practice address
3029 22ND Ave S Unit 316
Minneapolis, MN 55407-5010
Phone
(612) 200-6720
NPI assigned
Nov 18, 2024
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 1496192700023 MN Primary

Addresses

Primary practice location

3029 22ND Ave S Unit 316
Minneapolis, MN 55407-5010

Mailing address

3029 22ND Ave S Unit 316
Minneapolis, MN 55407-5010
Phone (612) 200-6720

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

State licenses

LicenseStateTypeSpecialty
1496192700023MNMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Growth Housing Services 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.

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1740005644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 22ND AVE S UNIT 316",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554075010",
            "telephone_number": "612-200-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3029 22ND AVE S UNIT 316",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554075010",
            "telephone_number": "612-200-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "ALI",
        "middle_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MN",
            "license": "1496192700023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.