Hailu T Kabtimer, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD0000030413 Issued in TN

Practice address

919 W Main St M3
Hendersonville, TN 37075

Phone

(615) 826-2102

Fax

(615) 826-2743

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1013009729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 W MAIN ST M3",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "37075",
            "telephone_number": "615-826-2102",
            "fax_number": "615-826-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 W MAIN ST M3",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "37075",
            "telephone_number": "615-826-2102",
            "fax_number": "615-826-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABTIMER",
        "first_name": "HAILU",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000030413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3843759",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.