Active NPI
Kaleb Negusse, PHARMD
- Pharmacist
- Arlington, VA
National Provider Identifier
1568059533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202215517
- Practice address
- 1201 S Hayes St
Arlington, VA 22202-2700 - Phone
- (703) 418-3790
- NPI assigned
- Dec 24, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202215517 | VA | Primary |
Addresses
Primary practice location
1201 S Hayes St
Arlington, VA 22202-2700
Mailing address
1201 S Hayes St
Arlington, VA 22202-2700
Phone (703) 418-3790
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | CVS | Health Information Exchange (HIE) |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202215517 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608768000000",
"number": "1568059533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 S HAYES ST",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222022700",
"telephone_number": "703-418-3790",
"fax_number": "703-418-3795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 S HAYES ST",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222022700",
"telephone_number": "703-418-3790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEGUSSE",
"first_name": "KALEB",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-24",
"last_updated": "2020-12-24",
"certification_date": "2020-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202215517",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "CVS",
"affiliation": "N",
"endpointDescription": "CVS",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1201 S Hayes St",
"city": "Arlington",
"state": "VA",
"country_code": "US",
"postal_code": "222022700",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.