Active NPI
Nebiat Mekonnen
- Pharmacist
- Burtonsville, MD
National Provider Identifier
1508427733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202217442
- Practice address
- 3623 Linganore Way
Burtonsville, MD 20866-1962 - Phone
- (703) 386-6837
- NPI assigned
- Jun 27, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH100003633 | DC | |
| Pharmacist | 183500000X | 0202217442 | VA | Primary |
Addresses
Primary practice location
3623 Linganore Way
Burtonsville, MD 20866-1962
Mailing address
3623 Linganore Way
Burtonsville, MD 20866-1962
Phone (703) 386-6837
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH100003633 | DC | MD | Pharmacist |
| 0202217442 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1508427733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3623 LINGANORE WAY",
"city": "BURTONSVILLE",
"state": "MD",
"postal_code": "208661962",
"telephone_number": "703-386-6837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3623 LINGANORE WAY",
"city": "BURTONSVILLE",
"state": "MD",
"postal_code": "208661962",
"telephone_number": "703-386-6837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEKONNEN",
"first_name": "NEBIAT",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-27",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DC",
"license": "PH100003633",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202217442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burtonsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.