NPIMap

Organization Active NPI

Anteneh Addisu MD PA

  • Internal Medicine Physician
  • Ocala, FL
National Provider Identifier
1730290875
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME75316 Issued in FL
Legal business name
ANTENEH ADDISU MD PA
Practice address
1431 SW 1St Ave
Ocala, FL 34471-6500
Phone
(352) 632-6104
Fax
(352) 861-4702
NPI assigned
Aug 31, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Anteneh Addisu, MD
Title
Owner
Phone
(352) 362-6104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME75316 FL Primary

Addresses

Primary practice location

1431 SW 1St Ave
Ocala, FL 34471-6500

Mailing address

PO Box 3716
Ocala, FL 34478-3716
Phone (352) 632-6104

National Provider Directory

National Provider Directory

Locations

3201 SW 34th Ave
Ste 205
Ocala, FL 34474
Phone (352) 897-1241

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1730290875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3716",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344783716",
            "telephone_number": "352-632-6104",
            "fax_number": "352-861-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 SW 1ST AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344716500",
            "telephone_number": "352-632-6104",
            "fax_number": "352-861-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTENEH ADDISU MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ADDISU",
        "authorized_official_first_name": "ANTENEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-362-6104",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME75316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.