Chernet Asfaw Desta, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

0202211082 Issued in VA

Practice address

388 Garrisonville Rd
Stafford, VA 22554-1529

Phone

(540) 659-7723

NPI assigned

Nov 30, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1982208013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40373",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222047373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541529",
            "telephone_number": "540-659-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTA",
        "first_name": "CHERNET",
        "middle_name": "ASFAW",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202211082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CVS",
            "identifier": "1974",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cvs",
            "affiliation": "N",
            "endpointDescription": "health",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "catemark",
            "address_1": "388 Garrisonville Rd",
            "city": "Stafford",
            "state": "VA",
            "country_code": "US",
            "postal_code": "225541529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cvs",
            "affiliation": "N",
            "endpointDescription": "health",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cvs",
            "address_1": "388 Garrisonville Rd",
            "city": "Stafford",
            "state": "VA",
            "country_code": "US",
            "postal_code": "225541529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Stafford, VA
• Providers in Stafford, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.