Individual provider Active NPI

Mohamed Mohamoud Mohamedabdh

  • Non-emergency Medical Transport (VAN)
  • Minneapolis, MN
National Provider Identifier
1962876722
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
300595677 Issued in MN
Practice address
912 E 24TH St
Ste B215
Minneapolis, MN 55404-3869
Phone
(507) 573-1608
NPI assigned
Nov 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 300595677 MN Primary
Home Health Agency 251E00000X 1566943 MN

Addresses

Primary practice location

912 E 24TH St
Ste B215
Minneapolis, MN 55404-3869

Mailing address

PO Box 28561
Saint Paul, MN 55128-0561
Phone (507) 573-1608

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
1566943MNMDHome Health Agency
300595677MNMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1962876722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28561",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551280561",
            "telephone_number": "507-573-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 E 24TH ST",
            "address_2": "STE B215",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043869",
            "telephone_number": "507-573-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMEDABDH",
        "first_name": "MOHAMED",
        "middle_name": "MOHAMOUD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MN",
            "license": "300595677",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "1566943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.