Active NPI
Michaeline Cooper Youngkendeh
- Registered Nurse
- Fargo, ND
National Provider Identifier
1043010291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R53621
- Practice address
- 3340 42ND St S Apt 314
Fargo, ND 58104-6940 - Phone
- (610) 803-5827
- Fax
- (610) 803-5827
- NPI assigned
- Mar 17, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 200679 | ND | |
| Registered Nurse | 163W00000X | R53621 | ND | Primary |
Addresses
Primary practice location
3340 42ND St S Apt 314
Fargo, ND 58104-6940
Mailing address
3340 42ND St S Apt 314
Fargo, ND 58104-6940
Phone (610) 803-5827
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
| License | State | Type | Specialty |
|---|---|---|---|
| 200679 | ND | MD | Registered Nurse |
| R53621 | ND | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magmary Home Care | Registered Nurse | Current | 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": "1742169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1043010291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 42ND ST S APT 314",
"city": "FARGO",
"state": "ND",
"postal_code": "581046940",
"telephone_number": "610-803-5827",
"fax_number": "610-803-5827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3340 42ND ST S APT 314",
"city": "FARGO",
"state": "ND",
"postal_code": "581046940",
"telephone_number": "610-803-5827",
"fax_number": "610-803-5827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGKENDEH",
"first_name": "MICHAELINE",
"middle_name": "COOPER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-17",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ND",
"license": "200679",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ND",
"license": "R53621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.