Individual provider Active NPI

Endalkachew Bireda

  • Pharmacist
  • Alexandria, VA
National Provider Identifier
1144825118
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202215083 Issued in VA
Practice address
3117 Lockheed Blvd
Alexandria, VA 22306-2002
Phone
(703) 768-0344
Fax
(703) 768-0717
NPI assigned
Nov 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202215083 VA Primary

Addresses

Primary practice location

3117 Lockheed Blvd
Alexandria, VA 22306-2002

Mailing address

260 S Reynolds St Apt 1006
Alexandria, VA 22304-4444
Phone (617) 888-1993

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
0202215083VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia CVS Pharmacy, L.L.C. PastSince Dec 6, 2020 Accepting new patients
Virginia CVS Pharmacy, L.L.C. PastSince Dec 6, 2020 Accepting new patients

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": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1144825118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 S REYNOLDS ST APT 1006",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044444",
            "telephone_number": "617-888-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 LOCKHEED BLVD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223062002",
            "telephone_number": "703-768-0344",
            "fax_number": "703-768-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIREDA",
        "first_name": "ENDALKACHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202215083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.