Yazezew Kebede Kiros, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Fishersville, VA
NPI 1467255166 · NPPES record last updated Jul 31, 2025
Key facts
- NPI
- 1467255166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 0116040305 (VA)
- Practice address
- 78 Medical Center Dr
Fishersville, VA 22939-2332 - Phone
- (540) 932-5595
- Fax
- (540) 932-5596
- NPI assigned
- Mar 28, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251028001206 | VA | Order and Referring Only - Internal Medicine |
4981193273 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0116040305 | VA | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- yazezew.kiros.1@14718.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 0116040305 | VA | Yes |
Addresses
Primary practice location
78 Medical Center Dr
Fishersville, VA 22939-2332
Mailing address
PO Box 388
Fishersville, VA 22939-0388
Phone (540) 332-5168
Other practice location 1
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-1000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | yazezew.kiros.1@14718.direct.athenahealth.com |
Other providers in Fishersville, VA
- Su Hee Kim
- Elizabeth King
- Jennifer M King
- Melody King
- Jakob Kinsey
- Christopher R Klimek
- Daphne Harrington Knicely
- Virginia H. Kockler
- Anagha D Kohli
- Ashlie Koiner
All providers in Fishersville, VA · Student in an Organized Health Care Education/Training Program in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.