Ethiopia Worku Gezahagn

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

201703240028964 Issued in TN

Practice address

2221 Beachfront Ave
Antioch, TN 37013-7425

Phone

(615) 424-4507

NPI assigned

Apr 4, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Graceful Living Residential Care, LLC

  • In Home Supportive Care Agency
  • Nashville, TN
  • NPI 1063257699
  NPD Authorized official

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1992238240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 RAVENNA CT N",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370131091",
            "telephone_number": "615-424-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 BEACHFRONT AVE",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370137425",
            "telephone_number": "615-424-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEZAHAGN",
        "first_name": "ETHIOPIA",
        "middle_name": "WORKU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "201703240028964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Ruccio
• Eman George
• Michael Graves Gerard, RN
• Chyna Niyae Germany-Rucker, BSN, RN
• Get Outside Therapy Services, LLC
• Tanya Michelle Gibbs, M.S.
• Shelby Elizabeth Gibson
• Mike David Glasmeier, DMD
• Godel & Associates TN PLLC
• Golden Cross Logistics, LLC

• All providers in Antioch, TN
• Home Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.