Hiwot Tadele Kebede, RRT

Primary specialty

Certified Respiratory TherapistTaxonomy code 227800000X

License

10904 Issued in GA

Practice address

1951 Mulberry Park Dr
Dacula, GA 30019-2068

Phone

(177) 036-9510

NPI assigned

May 6, 2021

Last updated

May 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1851975841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 MULBERRY PARK DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192068",
            "telephone_number": "177-036-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 MULBERRY PARK DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192068",
            "telephone_number": "177-036-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBEDE",
        "first_name": "HIWOT",
        "middle_name": "TADELE",
        "credential": "RRT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": "GA",
            "license": "10904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Modem",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1951 Mulberry Park Dr",
            "city": "Dacula",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300192068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Certified Respiratory Therapist in Dacula, GA
• Providers in Dacula, GA by specialty
• Certified Respiratory Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.