Eyobe Debebe Woldemariam

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2191836 Issued in MN

Practice address

7632 Sherwood Rd
Woodbury, MN 55125-2842

Phone

(651) 500-7790

NPI assigned

Aug 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Havenwood Care LLC

  • Assisted Living Facility
  • Burnsville, MN
  • NPI 1942142492
  NPD Authorized official
• Starlight Care LLC

  • Foster Care Agency
  • Woodbury, MN
  • NPI 1215638853
  NPD Authorized official

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

{
    "created_epoch": "1565395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1982250569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7632 SHERWOOD RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551252842",
            "telephone_number": "651-500-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7632 SHERWOOD RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252842",
            "telephone_number": "651-500-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDEMARIAM",
        "first_name": "EYOBE",
        "middle_name": "DEBEBE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-10",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2191836",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "2191836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Witte
• David Martin Witte, D.C.
• Ashlyn Rae Woeltge
• Darii Wohlers, OTR/L
• Helen Z Wolday, RPH
• Jeanne Wolfe, MA, LPCC
• Yanislav B Wolfson, MD
• Collin Woll, PT, DPT, LAT, ATC
• Abby Wollin, MA, LMFT
• Sharon M Wolters, M.D.

• Registered Nurse in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.