Wondemneh Alemneh Deresse, OWNER

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

B-10018 Issued in CO

Practice address

19142 E, Hampden Dr
Aurora, CO 80013

Phone

(720) 226-5915

Fax

(772) 264-5915

NPI assigned

Jul 29, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Wondemneh Alemneh Deresse Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Abenezer Holdings LLC

  • Non-emergency Medical Transport (VAN)
  • Aurora, CO
  • NPI 1447606967
  NPD (past)

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1487039657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19142 E HAMPDEN DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800135408",
            "telephone_number": "720-226-5915",
            "fax_number": "772-264-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19142 E, HAMPDEN DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80013",
            "telephone_number": "720-226-5915",
            "fax_number": "772-264-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERESSE",
        "first_name": "WONDEMNEH",
        "middle_name": "ALEMNEH",
        "name_prefix": "Mr.",
        "credential": "OWNER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CO",
            "license": "B-10018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WONDEMNEH",
            "last_name": "DERESSE",
            "middle_name": "ALEMNEH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alejandro Leonel Deras
• Gracia Maria Deras
• Dominique Kathryn Derbonne
• Diane Rica Derden
• Sarkis Christopher Derderian, M.D.
• Jeannae Marie Dergance, MD
• Catherine Derington, PHARMD
• Luise Deroche
• Emily Joyce Derose
• John Derrick, MSN, CPNP, APRN

• Non-emergency Medical Transport (VAN) in Aurora, CO
• Providers in Aurora, CO by specialty
• Non-emergency Medical Transport (VAN) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.