Individual provider Active NPI

Kaamilya Abdelhadi

  • Non-emergency Medical Transport (VAN)
  • Mobile, AL
National Provider Identifier
1902364102
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
C4099 Issued in AL
Practice address
2812 Brookside Dr
Mobile, AL 36693-3509
Phone
(251) 423-5292
NPI assigned
Mar 6, 2019
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X C4099 AL Primary

Addresses

Primary practice location

2812 Brookside Dr
Mobile, AL 36693-3509

Mailing address

2812 Brookside Dr
Mobile, AL 36693-3509
Phone (251) 423-5292

Other identifiers 3

IdentifierTypeStateIssuer
HL2SQJAYZMedicaidAL
C4099OtherALAPSC
B-88MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL http://www.taylorshouseofcamellias.com Health Information Exchange (HIE) Taylors House of Camellias LLC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C4099ALMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor's House of Camellias LLC Non-Emergency Medical Transport (Van) CurrentSince Mar 21, 2019 Accepting new patients

Organizations & group practices 1

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1902364102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 BROOKSIDE DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933509",
            "telephone_number": "251-423-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 BROOKSIDE DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933509",
            "telephone_number": "251-423-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELHADI",
        "first_name": "KAAMILYA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AL",
            "license": "C4099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HL2SQJAYZ",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APSC",
            "identifier": "C4099",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B-88",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.taylorshouseofcamellias.com",
            "affiliation": "Y",
            "endpointDescription": "Website",
            "affiliationName": "Taylors House of Camellias LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2812 Brookside Dr",
            "city": "Mobile",
            "state": "AL",
            "country_code": "US",
            "postal_code": "366933509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.