Zeritu Woyesa Mutal

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

1769421 Issued in MN

Practice address

12037 Waconia Cir NE
Blaine, MN 55449-5533

Phone

(612) 309-8940

NPI assigned

Oct 18, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Kayo Health Care Center LLC

  • Assisted Living Facility
  • Fridley, MN
  • NPI 1487475794
  NPD Authorized official

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1487475976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12037 WACONIA CIR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495533",
            "telephone_number": "612-309-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12037 WACONIA CIR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495533",
            "telephone_number": "612-309-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTAL",
        "first_name": "ZERITU",
        "middle_name": "WOYESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "1769421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Motion Rehab Physical Therapy LLC
• Mohamed Ahmed Muhumed
• Enid Lwiindi Mumba
• Murphy Bros Building & Remodeling
• Angela M Musland, O.D.
• MW Minnetonka Operating LLC
• Boniface Mwangi
• Jessica Leigh Naiberg, MS OTR/L
• Monyka Grace Naide
• Naimo Osman

• Home Health Registered Nurse in Blaine, MN
• Providers in Blaine, MN by specialty
• Home Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.