Individual provider Active NPI

Kidane Teklehaimanot, RPH

  • Pharmacist
  • Denver, CO
National Provider Identifier
1619314077
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15291 Issued in CO
Practice address
2810 Quebec St
Denver, CO 80207-2900
Phone
(303) 333-3837
Fax
(303) 333-8029
NPI assigned
May 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15291 CO Primary

Addresses

Primary practice location

2810 Quebec St
Denver, CO 80207-2900

Mailing address

2810 Quebec St
Pharmacy
Denver, CO 80207-2900
Phone (303) 333-3837

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
15291COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1619314077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 QUEBEC ST",
            "address_2": "PHARMACY",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072900",
            "telephone_number": "303-333-3837",
            "fax_number": "303-333-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 QUEBEC ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072900",
            "telephone_number": "303-333-3837",
            "fax_number": "303-333-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLEHAIMANOT",
        "first_name": "KIDANE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "15291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.