Individual provider Active NPI

Selomie Mequanint Kebede, M.D

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
National Provider Identifier
1801024708
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101258867 Issued in VA
Practice address
9530 Cosner Dr
Suite 200
Fredericksburg, VA 22408-7760
Phone
(540) 373-1331
Fax
(540) 373-1124
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101258867 VA Primary

Addresses

Primary practice location

9530 Cosner Dr
Suite 200
Fredericksburg, VA 22408-7760

Mailing address

9530 Cosner Dr
Suite 200
Fredericksburg, VA 22408-7760
Phone (540) 373-1331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170216000057 OH Practitioner - Cardiovascular Disease (Cardiology) 0143538470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Howard University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

955 Bethesda Dr
Zanesville, OH 43701-1873
Phone (740) 450-6147

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039
  • Southeastern Ohio Regional Medical Center Hospital, Cambridge, OH, CCN 360203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group LLC Cardiovascular Disease CurrentSince Feb 2, 2017 Accepting new patients
Genesis Medical Group, LLC CurrentSince Feb 2, 2017 Accepting new patients

Locations

61353 Southgate Rd
Ste 3
Cambridge, OH 43725
Phone (740) 450-3296

48439 Genesis Dr
Ste F
Coshocton, OH 43812
Phone (740) 623-4481

301 Mike Clouse Dr
#2A
Somerset, OH 43783
Phone (740) 836-0035

1246 Ashland Ave
Ste 204
Zanesville, OH 43701
Phone (740) 450-6167

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

955 Bethesda Dr
Ste D
Zanesville, OH 43701
Phone (740) 454-5000

955 Bethesda Dr
Fl 1
Zanesville, OH 43701
Phone (740) 454-0804

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1801024708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9530 COSNER DR",
            "address_2": "SUITE 200",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224087760",
            "telephone_number": "540-373-1331",
            "fax_number": "540-373-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9530 COSNER DR",
            "address_2": "SUITE 200",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224087760",
            "telephone_number": "540-373-1331",
            "fax_number": "540-373-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBEDE",
        "first_name": "SELOMIE",
        "middle_name": "MEQUANINT",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101258867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.