Individual provider Active NPI

Hamdi Abdi Hudle

  • Psychologist
  • St Louis Park, MN
National Provider Identifier
1922639640
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
4236 Park Glen Rd
St Louis Park, MN 55416-4758
Phone
(952) 888-7055
Fax
(612) 605-3312
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

4236 Park Glen Rd
St Louis Park, MN 55416-4758

Mailing address

4236 Park Glen Rd
St Louis Park, MN 55416-4758
Phone (952) 888-7055

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
Iska Inc PastSince Feb 2, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1922639640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4236 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164758",
            "telephone_number": "952-888-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4236 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164758",
            "telephone_number": "952-888-7055",
            "fax_number": "612-605-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDLE",
        "first_name": "HAMDI",
        "middle_name": "ABDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.