Active NPI
Alfred Zagba Jalarue
- Nurse's Aide
- Fargo, ND
National Provider Identifier
1255046736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 73791
- Practice address
- 3612 56TH St S
Fargo, ND 58104-4492 - Phone
- (720) 879-2629
- NPI assigned
- Jan 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 73791 | ND | Primary |
Addresses
Primary practice location
3612 56TH St S
Fargo, ND 58104-4492
Mailing address
3612 56TH St S
Fargo, ND 58104-4492
Phone (720) 879-2629
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Desttop | Health Information Exchange (HIE) | |
| CONNECT URL | API | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 73791 | ND | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674691200000",
"number": "1255046736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3612 56TH ST S",
"city": "FARGO",
"state": "ND",
"postal_code": "581044492",
"telephone_number": "720-879-2629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3612 56TH ST S",
"city": "FARGO",
"state": "ND",
"postal_code": "581044492",
"telephone_number": "720-879-2629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JALARUE",
"first_name": "ALFRED",
"middle_name": "ZAGBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-18",
"last_updated": "2023-01-26",
"certification_date": "2023-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "ND",
"license": "73791",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Desttop",
"affiliation": "N",
"endpointDescription": "API(URL)",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3612 56th St S",
"city": "Fargo",
"state": "ND",
"country_code": "US",
"postal_code": "581044492",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "API",
"affiliation": "N",
"endpointDescription": "URL",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3612 56th St S",
"city": "Fargo",
"state": "ND",
"country_code": "US",
"postal_code": "581044492",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jan 26, 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.