Individual provider Active NPI

PA M Jagne

  • Home Health Aide
  • Anchorage, AK
National Provider Identifier
1023350287
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
100821 Issued in AK
Practice address
1006 W 71St Ave
Anchorage, AK 99518-2118
Phone
(907) 764-9956
NPI assigned
Mar 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 100821 AK Primary

Addresses

Primary practice location

1006 W 71St Ave
Anchorage, AK 99518-2118

Mailing address

12441 Brandon St
Anchorage, AK 99515-3589
Phone (907) 764-9956

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

State licenses

LicenseStateTypeSpecialty
100821AKMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Jagne's Assisted Living Home Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1023350287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12441 BRANDON ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995153589",
            "telephone_number": "907-764-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W 71ST AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995182118",
            "telephone_number": "907-764-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGNE",
        "first_name": "PA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "AK",
            "license": "100821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.