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
- Last updated
- 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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.