Ibrahim A Abdulrahman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD60105626 Issued in WA

Practice address

3900 S Zintel Way
Kadlec Clinic - Kennewick Primary Care
Kennewick, WA 99338

Phone

(509) 942-3125

Fax

(509) 783-2167

NPI assigned

Sep 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bullhead City Clinic Corp

  dba Laughlin Walk In Care

  • Family Medicine Physician
  • Laughlin, NV
  • NPI 1700240884
  NPD (past)
• Bullhead City Clinic Corp

  • Surgery Physician
  • Bullhead City, AZ
  • NPI 1962429878
  NPD (past)
• CMG Partners, PC

  • Clinic/Center
  • Clarkston, MI
  • NPI 1932292166

  Internal Medicine

  NPD (past)
• Prevea Clinic, Inc.

  • Internal Medicine Physician
  • Green Bay, WI
  • NPI 1306869276
  NPD (past)
• Prevea Regional Services, Inc.

  dba Prevea Regional

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1194748061
  NPD (past)

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1801081948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 S ZINTEL WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99338",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 S ZINTEL WAY",
            "address_2": "KADLEC CLINIC - KENNEWICK PRIMARY CARE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99338",
            "telephone_number": "509-942-3125",
            "fax_number": "509-783-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULRAHMAN",
        "first_name": "IBRAHIM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60105626",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60105626",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER WA STATE",
            "identifier": "0306281",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801081948",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON MEDICAID",
            "identifier": "500625216",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omar Uriel Abarca
• Abc Optometric Services Inc (Clearwater Family Eye Care)
• Laili Abd Latif, MS RD CD
• Jarniful Mustafa Abdul Razek, THW000111369
• Abdullah Alkanan BDS PLLC
• Drew S Ableman, DO
• Accident Care Chiropractic PC (Accident Care Chiropractic of Kennewick)
• Christine A Acker, ARNP
• Acquire LTC Training
• Action Chiropractic Care LLC (Action Chiropractic)

• Pediatrics Physician in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.