Active NPI
Abebaw Dejene Tadesse, PHARMD
- Pharmacist
- Carlsbad, NM
National Provider Identifier
1568951945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP.00008869
- Practice address
- 1401 W Pierce St
Carlsbad, NM 88220-4024 - Phone
- (575) 887-0572
- NPI assigned
- May 1, 2018
- 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 | RP.00008869 | NM | Primary |
Addresses
Primary practice location
1401 W Pierce St
Carlsbad, NM 88220-4024
Mailing address
609 N Alameda St Apt 6
Carlsbad, NM 88220-5026
Phone (720) 277-7325
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 |
|---|---|---|---|
| RP.00008869 | NM | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Carlsbad, NM
- NPI 1174538078
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525132800000",
"number": "1568951945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 N ALAMEDA ST APT 6",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "882205026",
"telephone_number": "720-277-7325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 W PIERCE ST",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "882204024",
"telephone_number": "575-887-0572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TADESSE",
"first_name": "ABEBAW",
"middle_name": "DEJENE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-01",
"last_updated": "2018-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "RP.00008869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.