Individual provider Active NPI

Martha Kebede Mekonen, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1952967812
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34242 Issued in CA
Practice address
2667 Camino del Rio South
Suite #313
San Diego, CA 92108
Phone
(530) 643-7723
NPI assigned
May 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 34242 CA Primary
Nutrition Chiropractor 111NN1001X 34242 CA
Pediatric Chiropractor 111NP0017X 34242 CA
Rehabilitation Chiropractor 111NR0400X 34242 CA

Addresses

Primary practice location

2667 Camino del Rio South
Suite #313
San Diego, CA 92108

Mailing address

2667 Camino del Rio South
Suite #313
San Diego, CA 92108
Phone (530) 643-7723

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

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1952967812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2667 CAMINO DEL RIO SOUTH",
            "address_2": "SUITE #313",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92108",
            "telephone_number": "530-643-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2667 CAMINO DEL RIO SOUTH",
            "address_2": "SUITE #313",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92108",
            "telephone_number": "530-643-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEKONEN",
        "first_name": "MARTHA",
        "middle_name": "KEBEDE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34242",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "34242",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "CA",
            "license": "34242",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "34242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.