Individual provider Active NPI

Shengo Kibri Dawud

  • Technician
  • Saint Paul, MN
National Provider Identifier
1801611215
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
Practice address
1001 Westgate Dr
Saint Paul, MN 55114-1065
Phone
(612) 357-0642
NPI assigned
Nov 20, 2024
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X Primary

Addresses

Primary practice location

1001 Westgate Dr
Saint Paul, MN 55114-1065

Mailing address

470 Western Ave N
Saint Paul, MN 55103-2292
Phone (612) 357-0642

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

NPI Registry JSON

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1801611215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 WESTERN AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032292",
            "telephone_number": "612-357-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WESTGATE DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141065",
            "telephone_number": "612-357-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWUD",
        "first_name": "SHENGO",
        "middle_name": "KIBRI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.