Individual provider Active NPI

Kefali Teklemariam

  • Pharmacist
  • Chester, VA
National Provider Identifier
1104220359
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202213430 Issued in VA
Practice address
4408 W Hundred Rd
Chester, VA 23831-1738
Phone
(804) 768-1579
NPI assigned
Oct 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202213430 VA Primary

Addresses

Primary practice location

4408 W Hundred Rd
Chester, VA 23831-1738

Mailing address

4408 W Hundred Rd
Chester, VA 23831-1738

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
0202213430VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1104220359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4408 W HUNDRED RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4408 W HUNDRED RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311738",
            "telephone_number": "804-768-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLEMARIAM",
        "first_name": "KEFALI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202213430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.