Nurul Mohammed Islam, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

229085 Issued in NY

Practice address

41 Park Creek Dr
Greenville VA Outpatient Clinic
Greenville, SC 29605-4270

Phone

(864) 299-1600

NPI assigned

Oct 2, 2006

Last updated

Feb 28, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Columbia Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Greenville, SC
  • NPI 1265490155
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1861585580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PARK CREEK DR",
            "address_2": "GREENVILLE VA OUTPATIENT CLINIC",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054270",
            "telephone_number": "864-299-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 PARK CREEK DR",
            "address_2": "GREENVILLE VA OUTPATIENT CLINIC",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054270",
            "telephone_number": "864-299-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "NURUL",
        "middle_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01057305A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "229085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katheryn Dixon Isham, M.D.
• Marc Taro Ishizuka, D.O.
• Lynn-Marly Isidore
• Rebecca Alsip Iskandar, D.O.
• Samy R Iskandar, MD
• Mohammed A Ismail, BPHARM
• Naseem Haji Hussein Ismail, M.D.
• Jaime Suzanne Ison
• Shaher Issa
• Marcia Andrea Iszard, CRNA

• Family Medicine Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.