Active NPI
Dereje Beyene
- Critical Care Certified Respiratory Therapist
- Saint Cloud, MN
National Provider Identifier
1639682925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Certified Respiratory Therapist
- License
- 4049
- Practice address
- 1406 15TH Street North
Saint Cloud, MN 56303 - Phone
- (320) 251-2700
- NPI assigned
- Nov 9, 2017
- 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 |
|---|---|---|---|---|
| Critical Care Certified Respiratory Therapist | 2278C0205X | 4049 | MN | Primary |
Addresses
Primary practice location
1406 15TH Street North
Saint Cloud, MN 56303
Mailing address
1406 15TH Street North
Saint Cloud, MN 56303
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4049 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510185600000",
"number": "1639682925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 15TH STREET NORTH",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "56303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1406 15TH STREET NORTH",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "56303",
"telephone_number": "320-251-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEYENE",
"first_name": "DEREJE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-09",
"last_updated": "2017-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "2278C0205X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Certified, Critical Care",
"state": "MN",
"license": "4049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.