Abebe Medical LLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

ABEBE MEDICAL LLC

Practice address

3483 S Eastern Ave
Las Vegas, NV 89169-3314

Phone

(702) 309-2311

NPI assigned

Oct 17, 2021

Last updated

Oct 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Enzi Abebe, APRNNPI 1497102214

Title

Owner/Provider

Phone

(702) 588-8408

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Enzi Abebe, APRN

  • Gerontology Nurse Practitioner
  • Las Vegas, NV
  • NPI 1497102214
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1634428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634428800000",
    "number": "1972266989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 E AGATE AVE UNIT 408",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236061",
            "telephone_number": "702-588-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3483 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891693314",
            "telephone_number": "702-309-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABEBE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-17",
        "last_updated": "2021-10-17",
        "certification_date": "2021-10-17",
        "status": "A",
        "authorized_official_last_name": "ABEBE",
        "authorized_official_first_name": "ENZI",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "702-588-8408",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Abdullah
• Muhammad Daud Abdullah
• Sadiyyah Abdullah
• Sandra Lynn Abdullah, LCSW
• Fahmo Abdullahi
• Enzi Abebe, APRN
• Meseret Admasu Abebe
• Anwar Abedrabbo
• Frances Olajumoke Abegunde, M.ED., OTR/L, CLT
• Caridad Abejean

• Gerontology Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Gerontology Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.