Active NPI
Gashaw Tedla Tafari, MD
- Pediatrics Physician
- Rock Hill, SC
National Provider Identifier
1811941941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2019226
- Practice address
- 225 S Herlong Ave Ste 250
Rock Hill, SC 29732-2147 - Phone
- (803) 325-8742
- Fax
- (803) 325-2369
- NPI assigned
- May 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2019226 | SC | Primary |
Addresses
Primary practice location
225 S Herlong Ave Ste 250
Rock Hill, SC 29732-2147
Mailing address
6720 Joliette LN
Charlotte, NC 28277
Phone (704) 543-1388
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019226 | SC | MD | Pediatrics Physician |
| 19226 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Medicine Foundation | Past | Accepting new patients |
Interoperability endpoints
- gashaw.tafari.p1@direct.ncfmc.nextgenshare.com
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Chester, SC
- NPI 1356618318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1811941941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6720 JOLIETTE LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28277",
"telephone_number": "704-543-1388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 S HERLONG AVE STE 250",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297322147",
"telephone_number": "803-325-8742",
"fax_number": "803-325-2369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAFARI",
"first_name": "GASHAW",
"middle_name": "TEDLA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-22",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "2019226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.