Moallim Mohamed

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

PHCP013263 Issued in GA

Practice address

116 Ridge Creek Dr
Clarkston, GA 30021-2000

Phone

(678) 665-0570

NPI assigned

Jul 22, 2024

Last updated

Jul 22, 2024By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Nurture Home Care LLC

  • Home Health Agency
  • Clarkston, GA
  • NPI 1487476966
  NPD Authorized official

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1891523833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 RIDGE CREEK DR",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300212000",
            "telephone_number": "678-665-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 RIDGE CREEK DR",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300212000",
            "telephone_number": "678-665-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "MOALLIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "PHCP013263",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "RN323743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raven Martinez
• MCR Health, Inc. (Decatur Pediatric Group)
• Medcura Health, Inc.
• Mela Urgent and Primary Care Clinic LLC
• Hellen Moges
• Nazir A. Mousselli, D.C.
• Stephanie Rene Murray, M.A., CD-B/P, D.V.
• Jerome Ndikumukiza
• Yolanda Nesbitt, RN, BSN, CMGT-BC
• Trung The Nguyen

• Home Health Aide in Clarkston, GA
• Providers in Clarkston, GA by specialty
• Home Health Aide in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.