Individual provider Active NPI

Khalid Mohamed Abdullahi

  • In Home Supportive Care Agency
  • Saint Cloud, MN
National Provider Identifier
1861290207
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
1160 Suncrest Dr Apt 310
Saint Cloud, MN 56301-0015
Phone
(612) 806-6333
NPI assigned
Mar 3, 2025
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Child Physical Disabilities Respite Care 385HR2065X
In Home Supportive Care Agency 253Z00000X Primary
Community/Behavioral Health Agency 251S00000X
Behavior Technician 106S00000X

Addresses

Primary practice location

1160 Suncrest Dr Apt 310
Saint Cloud, MN 56301-0015

Mailing address

1160 Suncrest Dr Apt 310
Saint Cloud, MN 56301-0015
Phone (612) 806-6333

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Care Health LLC Community/Behavioral Health CurrentSince Oct 21, 2025 Accepting new patients
Thrive Autism Center L.L.C. PastSince Mar 1, 2025 Accepting new patients

Organizations & group practices 2

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": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1861290207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 SUNCREST DR APT 310",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563010015",
            "telephone_number": "612-806-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 SUNCREST DR APT 310",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563010015",
            "telephone_number": "612-806-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULLAHI",
        "first_name": "KHALID",
        "middle_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.