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Deactivated NPI 1962187914 Deactivated / Inactive NPI Male Practitioner

Ibrahim Mohamud Ibrahim

Driver • Milwaukee, WI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Ibrahim Ibrahim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 19, 2023
NPI Deactivation Date October 16, 2025
Total Practice Duration ~2 Years of Practice (2023 – 2025)

Professional Overview & Biography Verified Profile Summary

Ibrahim Ibrahim was a registered Driver practicing in Milwaukee, WI. Throughout an active medical career spanning 2 years, Ibrahim Ibrahim provided care at the practice location at 725 W LAPHAM BLVD APT 11 until profile deactivation on 2025-10-16.

Practice Location & Contact Primary Location

Practice Address

725 W Lapham Blvd Apt 11

Milwaukee, WI 532043446

Telephone 7164310218
Associated Practice Facility / Clinic
🏢 K B K Llc Transport Facility NPI 1417632464

Specialty Benchmarks & Practice Insights

Comparative analytics for Driver in Milwaukee, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
164 Specialists

Practicing in Milwaukee, WI (262 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Driver Primary Specialty

NUCC Taxonomy Code: 172A00000X

State License WI I1654139547107

A person employed to operate a motor vehicle as a carrier of persons or property.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated October 16, 2025

Record deactivated on October 16, 2025

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NPI Profile Deactivated October 15, 2025

Record deactivated on October 15, 2025

NPI Profile Active June 19, 2023

NPI status registered as active in NPPES database

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Updated Practice Location June 19, 2023

Registered at 725 W LAPHAM BLVD APT 11, MILWAUKEE, WI 532043446 (Tel: 7164310218)

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Updated Business Mailing Address June 19, 2023

Registered at 725 W LAPHAM BLVD APT 11, MILWAUKEE, WI 532043446 (Tel: 7164310218)

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Provider Name / Credentials Updated June 19, 2023

Recorded as IBRAHIM IBRAHIM

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 19, 2023

Driver (License #I1654139547107 in WI)

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Initial NPI Registration & Enumeration June 19, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1962187914
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 19, 2023
Last Update: June 19, 2023
Deactivation Date: October 16, 2025

Mailing Address

725 W Lapham Blvd Apt 11

Milwaukee, WI 532043446

Phone: 7164310218

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.