Individual provider Active NPI

Paul Kim Georgeson

  • Personal Care Attendant
  • Devils Lake, ND
National Provider Identifier
1245929413
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
817 3Rd Ave NE Apt 2
Devils Lake, ND 58301-2103
Phone
(507) 216-2448
NPI assigned
May 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

817 3Rd Ave NE Apt 2
Devils Lake, ND 58301-2103

Mailing address

502 12TH Ave SE Lot 19
Devils Lake, ND 58301-3815
Phone (507) 512-9267

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

NPI Registry JSON

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1245929413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 12TH AVE SE LOT 19",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013815",
            "telephone_number": "507-512-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 3RD AVE NE APT 2",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012103",
            "telephone_number": "507-216-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGESON",
        "first_name": "PAUL",
        "middle_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.