| Rapha Medical Center Llc | |
|
179 London Ct Ruckersville VA 22968-3367 | |
| (434) 249-9752 | |
| Not Available |
| Full Name | Rapha Medical Center Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 179 London Ct, Ruckersville, Virginia |
| Authorized Official Name and Position | Tilahun Mekonnen Goshu (CEO) |
| Authorized Official Contact | 4342499752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rapha Medical Center Llc 179 London Ct Ruckersville VA 22968-3367 Ph: (434) 249-9752 | Rapha Medical Center Llc 179 London Ct Ruckersville VA 22968-3367 Ph: (434) 249-9752 |
| NPI Number | 1932973021 |
|---|---|
| Provider Enumeration Date | 11/09/2023 |
| Last Update Date | 03/04/2024 |
| Medicare PECOS PAC ID | 7618327081 |
|---|---|
| Medicare Enrollment ID | O20231227001801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932973021 | NPI | - | NPPES |
| Provider Name | Mesele Alemu Gebreyes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114150067 PECOS PAC ID: 2062559206 Enrollment ID: I20091021000353 |
| Provider Name | Annette G Tarpley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629370895 PECOS PAC ID: 3577746106 Enrollment ID: I20110321000007 |
| Provider Name | Yalemwork Yigzaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649677394 PECOS PAC ID: 9931423605 Enrollment ID: I20150129000454 |
| Provider Name | Lee G Staley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447566021 PECOS PAC ID: 4284934332 Enrollment ID: I20151123001085 |
| Provider Name | Tilahun Goshu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336628551 PECOS PAC ID: 2567700107 Enrollment ID: I20190206002779 |
| Provider Name | Carrie Ann Herrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619517653 PECOS PAC ID: 4688097348 Enrollment ID: I20200714001238 |
| Provider Name | Vincent P Ly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144729724 PECOS PAC ID: 2769887397 Enrollment ID: I20210819003928 |
| Provider Name | Solomon Okwueze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700554763 PECOS PAC ID: 7618369794 Enrollment ID: I20221102003403 |
| Provider Name | Kathy Diane Thomason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750098794 PECOS PAC ID: 6204207400 Enrollment ID: I20230126001605 |
| Provider Name | Emmanuel Kwarfo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427774728 PECOS PAC ID: 7113371253 Enrollment ID: I20230923000769 |
| Provider Name | Rohina Ahmed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770364861 PECOS PAC ID: 3274980578 Enrollment ID: I20231108000963 |
| Provider Name | Kathryn Mckelvie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497345367 PECOS PAC ID: 3173928678 Enrollment ID: I20240802000137 |
| Provider Name | Misrak Girma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982467155 PECOS PAC ID: 2365979812 Enrollment ID: I20241220003420 |
| Provider Name | Wubeshet Teshome Tesema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134760036 PECOS PAC ID: 6709212889 Enrollment ID: I20250324003773 |