Individual provider Active NPI

Workinesh Abdella Woticha

  • Home Health Aide
  • Saint Paul, MN
National Provider Identifier
1306468178
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
1101666 Issued in MN
Practice address
493 Aurora Ave
Saint Paul, MN 55103-2218
Phone
(651) 855-8048
Fax
(651) 621-7732
NPI assigned
May 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health AideGroup: 193400000X SINGLE SPECIALTY GROUP 374U00000X 1101666 MN Primary

Addresses

Primary practice location

493 Aurora Ave
Saint Paul, MN 55103-2218

Mailing address

493 Aurora Ave
Saint Paul, MN 55103-2218
Phone (651) 855-8048

Other identifiers 1

IdentifierTypeStateIssuer
A773910000OtherMNDHS

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
1101666MNMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1306468178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 AURORA AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032218",
            "telephone_number": "651-855-8048",
            "fax_number": "651-621-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 AURORA AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032218",
            "telephone_number": "651-855-8048",
            "fax_number": "651-621-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOTICHA",
        "first_name": "WORKINESH",
        "middle_name": "ABDELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": "MN",
            "license": "1101666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS",
            "identifier": "A773910000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.