Mezgebua Tadesse Admassu, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN117786 Issued in OH

Practice address

498 S. Hamilton Rd
Apt #50
Columbus, OH 43213-4003

Phone

(614) 575-8566

NPI assigned

Nov 3, 2011

Last updated

Nov 3, 2011By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1811273949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 S HAMILTON RD APT 50",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432134003",
            "telephone_number": "614-575-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 S. HAMILTON RD",
            "address_2": "APT #50",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432134003",
            "telephone_number": "614-575-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADMASSU",
        "first_name": "MEZGEBUA",
        "middle_name": "TADESSE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN117786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN",
            "identifier": "117786",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN",
            "identifier": "PN117786",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Columbus, OH
• Providers in Columbus, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.