Active NPI
Martha Kebede Mekonen, D.C.
- Chiropractor
- San Diego, CA
National Provider Identifier
1952967812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 34242
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.