North Dakota Assistive

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

NORTH DAKOTA ASSISTIVE

Practice address

3240 15TH St S Ste B
Fargo, ND 58104-6188

Phone

(701) 365-4728

Fax

(701) 365-6242

NPI assigned

Oct 15, 2020

Organization subpart

No

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

Authorized official

Name

Sheila M Ellingson

Title

Business Manager

Phone

(701) 365-4728

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1164020749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 15TH ST S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046188",
            "telephone_number": "701-365-4728",
            "fax_number": "701-365-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 15TH ST S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046188",
            "telephone_number": "701-365-4728",
            "fax_number": "701-365-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DAKOTA ASSISTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "ELLINGSON",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "701-365-4728"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.