Active NPI
Ericka Booker
- Personal Care Attendant
- Minot, ND
National Provider Identifier
1265032031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- 1475328
- Practice address
- 4616 17TH Ave SE
Minot, ND 58701-6106 - Phone
- (701) 509-3449
- NPI assigned
- Oct 29, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 1475328 | ND | Primary |
Addresses
Primary practice location
4616 17TH Ave SE
Minot, ND 58701-6106
Mailing address
4616 17TH Ave SE
Minot, ND 58701-6106
Phone (701) 509-3449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ND3836930 | Medicaid | ND |
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 |
|---|---|---|---|
| 1475328 | ND | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603929600000",
"number": "1265032031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4616 17TH AVE SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587016106",
"telephone_number": "701-509-3449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4616 17TH AVE SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587016106",
"telephone_number": "701-509-3449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOKER",
"first_name": "ERICKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-29",
"last_updated": "2020-10-29",
"certification_date": "2020-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "ND",
"license": "1475328",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ND3836930",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.