NPIMap

Organization Active NPI

Ghebru Woldemichael MD LLC

  • Urology Physician
  • Yuma, AZ
National Provider Identifier
1154749422
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
AW3117454 Issued in AZ
Legal business name
GHEBRU WOLDEMICHAEL MD LLC
Practice address
2851 S Avenue B
Suite 2601
Yuma, AZ 85364-7726
Phone
(928) 317-9562
Fax
(928) 726-1588
NPI assigned
Apr 2, 2014
Last updated
Apr 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Authorized official

Name
Dr. Ghebru W Woldemichael, M.D.NPI 1588729065
Title
Owner
Phone
(928) 317-9562

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X AW3117454 AZ Primary

Addresses

Primary practice location

2851 S Avenue B
Suite 2601
Yuma, AZ 85364-7726

Mailing address

2851 S Avenue B
Suite 2601
Yuma, AZ 85364-7726
Phone (928) 317-9562

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5714/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396396800000",
    "number": "1154749422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 S AVENUE B",
            "address_2": "SUITE 2601",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647726",
            "telephone_number": "928-317-9562",
            "fax_number": "928-726-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 S AVENUE B",
            "address_2": "SUITE 2601",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647726",
            "telephone_number": "928-317-9562",
            "fax_number": "928-726-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHEBRU WOLDEMICHAEL MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-02",
        "last_updated": "2014-04-02",
        "status": "A",
        "authorized_official_last_name": "WOLDEMICHAEL",
        "authorized_official_first_name": "GHEBRU",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-317-9562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "AZ",
            "license": "AW3117454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.