Individual provider Active NPI

Fre Hagos Tesfatsion

  • Personal Care Attendant
  • Columbus, OH
National Provider Identifier
1912725342
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
602721460224 Issued in OH
Practice address
3400 Westerville Woods Dr
Columbus, OH 43231-7352
Phone
(614) 556-9663
NPI assigned
Oct 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X 602721460224 OH Primary

Addresses

Primary practice location

3400 Westerville Woods Dr
Columbus, OH 43231-7352

Mailing address

3400 Westerville Woods Dr
Columbus, OH 43231-7352
Phone (614) 556-9663

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

LicenseStateTypeSpecialty
602721460224OHMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1912725342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 WESTERVILLE WOODS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432317352",
            "telephone_number": "614-556-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 WESTERVILLE WOODS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432317352",
            "telephone_number": "614-556-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESFATSION",
        "first_name": "FRE",
        "middle_name": "HAGOS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "OH",
            "license": "602721460224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.