Tony Ibraham, REGISTERED NURSE

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN532456 Issued in OH

Practice address

925 Keynote Cir Ste 300
Brooklyn Heights, OH 44131-1869

Phone

(216) 931-1391

NPI assigned

Sep 19, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1801623145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 KEYNOTE CIR STE 300",
            "city": "BROOKLYN HEIGHTS",
            "state": "OH",
            "postal_code": "441311869",
            "telephone_number": "216-931-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 KEYNOTE CIR STE 300",
            "city": "BROOKLYN HEIGHTS",
            "state": "OH",
            "postal_code": "441311869",
            "telephone_number": "216-931-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHAM",
        "first_name": "TONY",
        "name_prefix": "Mr.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN532456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Registered Nurse in Brooklyn Heights, OH
• Providers in Brooklyn Heights, OH by specialty
• Psychiatric/Mental Health Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.