FEYISSA JAFAR WAGESSO
NPI 1699511253
Assisted Living Facility in Maplewood, MN

Q: What is Feyissa Wagesso's NPI number?

The NPI number for Feyissa Wagesso is 1699511253. It was assigned to this individual provider in the NPPES registry on July 3, 2024.

Q: What is Feyissa Wagesso's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Q: When was this NPI record last updated?

The NPPES record for Feyissa Wagesso was last updated on August 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 03, 2024

2468 BRENNER AVE E, MAPLEWOOD, MN 55109(763) 910-7300(218) 979-7692 Get Directions Write a Review

NPPES record last updated: August 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 8, 2025, Jul 7, 2024 (2 updates tracked since 2024).

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About Feyissa Jafar Wagesso NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FEYISSA JAFAR WAGESSO (NPI 1699511253) is an individual assisted living facility provider in Maplewood, Minnesota and active in the NPI registry since July 2024.

NPPES Registry Identity

NPI1699511253

Entity TypeIndividualMale

Primary Taxonomy310400000X

Provider Legal NameFEYISSA JAFAR WAGESSO

Location Address2468 BRENNER AVE EMaplewood, MN 55109-1573

Mailing Address2468 Brenner Ave EMaplewood, MN 55109-1573 · (763) 910-7300 · Fax (218) 979-7692

Phone(763) 910-7300

Fax(218) 979-7692

Sole ProprietorYes

Enumeration DateJuly 3, 2024

Last NPPES UpdateAugust 8, 20252 updates tracked since enumeration

NPPES CertifiedAugust 8, 2025

✔ NPI 1699511253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Also ListedAssisted Living Facility · Assisted Living, Behavioral DisturbancesTaxonomy 3104A0630X

2468 BRENNER AVE E, Maplewood, MN 55109

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Other Identifiers 1

MedicaidA636435500MN

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Feyissa Wagesso's NPI number?

The NPI number for Feyissa Wagesso is 1699511253. It was assigned to this individual provider in the NPPES registry on July 3, 2024.

Where is Feyissa Wagesso located?

Feyissa Wagesso practices at 2468 Brenner Ave E, Maplewood, MN 55109. The listed phone number is (763) 910-7300.

What is Feyissa Wagesso's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Feyissa Wagesso was last updated on August 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.