Individual provider Active NPI

Jessica Ashley Borsum, RN, BSN

  • Registered Nurse
  • Minot, ND
National Provider Identifier
1013595487
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R36821 Issued in ND
Practice address
2710 20TH Ave SW Apt 107
Minot, ND 58701-6874
Phone
(701) 500-2875
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R36821 ND Primary

Addresses

Primary practice location

2710 20TH Ave SW Apt 107
Minot, ND 58701-6874

Mailing address

2710 20TH Ave SW Apt 107
Minot, ND 58701-6874
Phone (701) 500-2875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R36821NDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1013595487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 20TH AVE SW APT 107",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016874",
            "telephone_number": "701-500-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 20TH AVE SW APT 107",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016874",
            "telephone_number": "701-500-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORSUM",
        "first_name": "JESSICA",
        "middle_name": "ASHLEY",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R36821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.