Tsgie Kidanemariam Hailu, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0002099256 Issued in VA

Practice address

4213 Walney Rd
Chantilly, VA 20151-2923

Phone

(703) 502-7000

NPI assigned

Apr 3, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Fairfax County, Virginia

  dba Fairfax-Falls Church Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfax, VA
  • NPI 1154356244
  NPD
• Fairfax Falls Church Community Service Board

  • Substance Abuse Rehabilitation Facility
  • Chantilly, VA
  • NPI 1104161736
  NPD (past)

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1700581295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 DOVER LN APT 204",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220422916",
            "telephone_number": "703-884-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 WALNEY RD",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512923",
            "telephone_number": "703-502-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILU",
        "first_name": "TSGIE",
        "middle_name": "KIDANEMARIAM",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002099256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Hackelton
• Hamdi Hagiyusuf, FNP
• Alexandra Helen Hagy
• Yasmeen Haider, M.D.
• Michael Haile
• Hibo Ismail Haji Jama
• Devin Hall
• Anne-Marie Rose Halstead, OTR/L
• Eleni Halstead, RN
• Nafisa Adil Abdalmaged Hamadto

• Licensed Practical Nurse in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Licensed Practical Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.