Individual provider Active NPI

Abduahman W Jama, MANAGER

  • Home Health Aide
  • Edina, MN
National Provider Identifier
1932575636
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
388010 Issued in MN
Practice address
7400 Metro Blvd Ste 150
Edina, MN 55439-2301
Phone
(529) 222-5477
Fax
(952) 222-5418
NPI assigned
Aug 17, 2015
Last updated
May 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X MN
Home Health Aide 374U00000X 388010 MN Primary
Nursing Home Administrator 376G00000X 388010 MN
Homemaker 376J00000X NU

Addresses

Primary practice location

7400 Metro Blvd Ste 150
Edina, MN 55439-2301

Mailing address

7400 Metro Blvd Ste 150
Minneapolis, MN 55439-2301
Phone (952) 222-5477

Other identifiers 1

IdentifierTypeStateIssuer
251J00000XOtherMNHOME HEALTH AGENCY

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

State licenses

LicenseStateTypeSpecialty
388010MNMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Home Health Care, Inc Current Accepting new patients
Mercy Link, LLC CurrentSince Jul 28, 2019 Accepting new patients

Locations

7400 Metro Blvd
Ste 150
Minneapolis, MN 55439
Phone (529) 222-5477

Organizations & group practices 2

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": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1932575636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 150",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554392301",
            "telephone_number": "952-222-5477",
            "fax_number": "952-222-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 150",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392301",
            "telephone_number": "529-222-5477",
            "fax_number": "952-222-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMA",
        "first_name": "ABDUAHMAN",
        "middle_name": "W",
        "credential": "MANAGER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-17",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MN",
            "license": "388010",
            "primary": true
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "MN",
            "license": "388010",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY",
            "identifier": "251J00000X",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.