Individual provider Active NPI

Yewlsow Ferede, PHARMD

  • Pharmacist
  • Baltimore, MD
National Provider Identifier
1770945420
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
23944 Issued in MD
Practice address
5624 Baltimore National Pike
Baltimore, MD 21228-1401
Phone
(410) 719-7608
NPI assigned
Mar 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202214256 VA
Pharmacist 183500000X PH100002134 DC
Pharmacist 183500000X 23944 MD Primary

Addresses

Primary practice location

5624 Baltimore National Pike
Baltimore, MD 21228-1401

Mailing address

3700 Falls Rd
Baltimore, MD 21211-1813
Phone (410) 467-7004

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

LicenseStateTypeSpecialty
23944MDMDClinical Social Worker
PH100002134DCMDPharmacist
0202214256VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1770945420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111813",
            "telephone_number": "410-467-7004",
            "fax_number": "410-467-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5624 BALTIMORE NATIONAL PIKE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212281401",
            "telephone_number": "410-719-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEREDE",
        "first_name": "YEWLSOW",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202214256",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DC",
            "license": "PH100002134",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "23944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.