Active NPI
Bereket Shimeles
- Pharmacist
- Fairfax, VA
National Provider Identifier
1831481563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202210254
- Practice address
- 3905 Fair Ridge Dr
Fairfax, VA 22033-2906 - Phone
- (703) 877-0580
- NPI assigned
- May 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202210254 | VA | Primary |
Addresses
Primary practice location
3905 Fair Ridge Dr
Fairfax, VA 22033-2906
Mailing address
5597 Seminary Rd Apt 111S
Falls Church, VA 22041-2684
Phone (202) 352-7652
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202210254 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Teeter LLC | Past | Accepting new patients | |
| Harris Teeter, LLC | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Fairfax, VA
- NPI 1598093627
-
- Community/Retail Pharmacy
- Apex, NC
- NPI 1225856859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305244800000",
"number": "1831481563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5597 SEMINARY RD APT 111S",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220412684",
"telephone_number": "202-352-7652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3905 FAIR RIDGE DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332906",
"telephone_number": "703-877-0580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMELES",
"first_name": "BEREKET",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-13",
"last_updated": "2011-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202210254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.