Adil Ahmed Abdurahaman
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Memphis, TN
NPI 1962298299 · NPPES record last updated Apr 15, 2025
Key facts
- NPI
- 1962298299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 877 Jefferson Ave
Memphis, TN 38103-2807 - Phone
- (901) 545-7100
- NPI assigned
- Apr 15, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250521001282 | TN | Order and Referring Only - Psychiatry |
8224557434 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
877 Jefferson Ave
Memphis, TN 38103-2807
Mailing address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-7100
Other providers in Memphis, TN
- Charity Renee Abdu
- Ahmad Bashar Abdulkarim
- Abdullah N. Abdullah
- Faria Abdullah
- Syidah Abdullah
- Kaitlin Vaughan Abel
- Jesse Abell
- Jadie Thompson Abendroth
- John F. Abercrombie
- Hazel Aberdeen
All providers in Memphis, TN · Student in an Organized Health Care Education/Training Program in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.