NPIMap

Individual provider Active NPI

Kalkidan Mamo

  • Pharmacist
  • Silver Spring, MD
National Provider Identifier
1831833631
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27760 Issued in MD
Practice address
10141 Colesville Rd
Silver Spring, MD 20901-2457
Phone
(301) 593-5252
NPI assigned
Apr 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 27760 MD Primary

Addresses

Primary practice location

10141 Colesville Rd
Silver Spring, MD 20901-2457

Mailing address

3701 S George Mason Dr Unit 212N
Falls Church, VA 22041-3776
Phone (240) 784-6745

Other names 1

  • Kalkidan Mamo Professional name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland CVS Pharmacy, L.L.C. PastSince May 1, 2022 Accepting new patients
Maryland CVS Pharmacy LLC PastSince May 1, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1831833631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 S GEORGE MASON DR UNIT 212N",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220413776",
            "telephone_number": "240-784-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10141 COLESVILLE RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209012457",
            "telephone_number": "301-593-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMO",
        "first_name": "KALKIDAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "27760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALKIDAN",
            "last_name": "MAMO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.