Active NPI
Ahmednur Abdirahman
- General Practice Physician
- Bloomington, MN
National Provider Identifier
1760724827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 2960569
- Practice address
- 10750 Brunswick Rd Apt 111
Bloomington, MN 55438-1860 - Phone
- (612) 203-6165
- NPI assigned
- Mar 26, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 2960569 | MN | Primary |
Addresses
Primary practice location
10750 Brunswick Rd Apt 111
Bloomington, MN 55438-1860
Mailing address
10750 Brunswick Rd Apt 111
Bloomington, MN 55438-1860
Phone (612) 203-6165
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2960569 | Other | MN | HOME HEALTH CARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2960569 | MN | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1760724827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10750 BRUNSWICK RD APT 111",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554381860",
"telephone_number": "612-203-6165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10750 BRUNSWICK RD APT 111",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554381860",
"telephone_number": "612-203-6165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDIRAHMAN",
"first_name": "AHMEDNUR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-26",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MN",
"license": "2960569",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOME HEALTH CARE",
"identifier": "2960569",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.