Active NPI
Kaamilya Abdelhadi
- Non-emergency Medical Transport (VAN)
- Mobile, AL
National Provider Identifier
1902364102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-emergency Medical Transport (VAN)
- License
- C4099
- Practice address
- 2812 Brookside Dr
Mobile, AL 36693-3509 - Phone
- (251) 423-5292
- NPI assigned
- Mar 6, 2019
- Last updated
- Mar 1, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HL2SQJAYZ | Medicaid | AL | |
| C4099 | Other | AL | APSC |
| B-88 | Medicaid | AL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| C4099 | AL | MD | Non-emergency Medical Transport (VAN) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taylor's House of Camellias LLC | Non-Emergency Medical Transport (Van) | Current | 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.
-
dba Taylor's House of Camellias Transportation
- Private Vehicle
- Mobile, AL
- NPI 1952000721
Non-Emergency Medical Transport (Van)
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.