Active NPI
Kidanewold T Geda, PHARMD
- Pharmacotherapy Pharmacist
- Dover, DE
National Provider Identifier
1033455241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- A10003410
- Practice address
- 1404 Forrest Ave Ste 5
Dover, DE 19904-3478 - Phone
- (302) 741-2273
- Fax
- (302) 741-2278
- NPI assigned
- Dec 14, 2012
- Last updated
- Mar 21, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | A10003410 | DE | Primary |
Addresses
Primary practice location
1404 Forrest Ave Ste 5
Dover, DE 19904-3478
Mailing address
1404 Forrest Ave Ste 5
Dover, DE 19904-3478
Phone (302) 741-2273
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A10003410 | DE | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490054400000",
"number": "1033455241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1404 FORREST AVE STE 5",
"city": "DOVER",
"state": "DE",
"postal_code": "199043478",
"telephone_number": "302-741-2273",
"fax_number": "302-741-2278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 FORREST AVE STE 5",
"city": "DOVER",
"state": "DE",
"postal_code": "199043478",
"telephone_number": "302-741-2273",
"fax_number": "302-741-2278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEDA",
"first_name": "KIDANEWOLD",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-14",
"last_updated": "2017-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "DE",
"license": "A10003410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.