Galassa Gabissa Jibraruk, HOME HEALTH AIDE

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

3651757 Issued in OH

Practice address

4887 Betsy Dr
Columbus, OH 43227-2122

Phone

(220) 262-2954

NPI assigned

Oct 11, 2023

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

• Tadesse Teklu Gebreyesus Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1508647975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887 BETSY DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432272122",
            "telephone_number": "220-262-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4887 BETSY DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432272122",
            "telephone_number": "220-262-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIBRARUK",
        "first_name": "GALASSA",
        "middle_name": "GABISSA",
        "credential": "HOME HEALTH AIDE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-11",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "3651757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TADESSE",
            "last_name": "GEBREYESUS",
            "middle_name": "TEKLU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Xiujun Jian, DMD
• Joanna J. Jiang, MD
• Justin Jiang
• Peng Jiang, PHARMD, LAC
• Robert Jiang, M.D.
• Jigg, LLC
• James Matthew Jilek
• Kathryn Jilek, LSW
• Maurice Jiles
• Amin Mohamed Jimale, APRN

• Nurse's Aide in Columbus, OH
• Providers in Columbus, OH by specialty
• Nurse's Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.