Active NPI
Tsedal Beyene Kidane, RPH
- Pharmacist
- Waxhaw, NC
National Provider Identifier
1376833244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15329
- Practice address
- 8101 Kensington Dr
Waxhaw, NC 28173-0103 - Phone
- (704) 843-7131
- Fax
- (704) 843-7621
- NPI assigned
- Apr 13, 2011
- Last updated
- Apr 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15329 | NC | Primary |
Addresses
Primary practice location
8101 Kensington Dr
Waxhaw, NC 28173-0103
Mailing address
4906 Mesa Vara Road
Charlotte, NC 28277
Phone (704) 321-9956
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
- Credentials
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| North Carolina CVS Pharmacy LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302652800000",
"number": "1376833244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4906 MESA VARA ROAD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28277",
"telephone_number": "704-321-9956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8101 KENSINGTON DR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281730103",
"telephone_number": "704-843-7131",
"fax_number": "704-843-7621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDANE",
"first_name": "TSEDAL",
"middle_name": "BEYENE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-13",
"last_updated": "2011-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "15329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.