Individual provider Active NPI

Rediet Regassa Gebeyehu, MD

  • Hematology & Oncology Physician
  • Winston Salem, NC
National Provider Identifier
1487069761
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2021-00819 Issued in NC
Practice address
1 Medical Center Blvd
Winston Salem, NC 27157-1212
Phone
(336) 716-2011
NPI assigned
Jun 25, 2014
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2021-00819 NC
Internal Medicine Physician 207R00000X 006765 GA
Internal Medicine Physician 207R00000X 078038 GA
Hematology & Oncology Physician 207RH0003X 2021-00819 NC Primary
Hospitalist Physician 208M00000X 078038 GA

Addresses

Primary practice location

1 Medical Center Blvd
Winston Salem, NC 27157-1212

Mailing address

1 Medical Center Boulevard
Winston Salem, NC 27157-0001
Phone (336) 716-2011

Other practice location 1

105 N Crutchfield St # 2
Dobson, NC 27017-8804
Phone (888) 789-2922

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgebeyehu@mtnvalleyhospice.org

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
006765GAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: rediet.gebeyehu.p48@direct.tenet.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1487069761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271571212",
            "telephone_number": "336-716-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 N Crutchfield St # 2",
            "address_purpose": "LOCATION",
            "city": "Dobson",
            "state": "NC",
            "postal_code": "270178804",
            "country_code": "US",
            "telephone_number": "888-789-2922",
            "fax_number": "336-789-0856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEBEYEHU",
        "first_name": "REDIET",
        "middle_name": "REGASSA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2021-00819",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "006765",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "078038",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2021-00819",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "078038",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgebeyehu@mtnvalleyhospice.org",
            "affiliation": "N",
            "address_1": "105 N Crutchfield St # 2",
            "city": "Dobson",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270178804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.