Individual provider Active NPI

Hamere B. Mekonnen, MD

  • Family Medicine Physician
  • Colonial Heights, VA
National Provider Identifier
1144800848
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101283417 Issued in VA
Practice address
524 Southpark Blvd
Colonial Heights, VA 23834-3609
Phone
(713) 674-3326
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 0101283417 VA Primary

Addresses

Primary practice location

524 Southpark Blvd
Colonial Heights, VA 23834-3609

Mailing address

3948 Brickert PL
Woodbridge, VA 22192-7447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260131000320 VA Practitioner - Family Practice 3870071889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Physician Partners LLCGroup PAC ID 2466581772, 258 clinicians

Practice addresses (Care Compare)

14349 Gideon Dr
FL 2
Woodbridge, VA 22192-4641
Phone (571) 472-8762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101283417VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC Family Medicine CurrentSince Jan 20, 2026 Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

740 E Main St
Purcellville, VA 20132
Phone (540) 338-4995

14349 Gideon Dr
Fl 2
Woodbridge, VA 22192
Phone (571) 472-8760

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1144800848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 BRICKERT PL",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221927447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 SOUTHPARK BLVD",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238343609",
            "telephone_number": "713-674-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKONNEN",
        "first_name": "HAMERE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101283417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.