Active NPI
Jacques Dominic Dubois, R.N.
- Home Health Registered Nurse
- Saint Paul, MN
National Provider Identifier
1306135462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 188706-0
- Practice address
- 308 Brimhall St
Saint Paul, MN 55105-2430 - Phone
- (651) 698-8115
- NPI assigned
- Mar 29, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 188706-0 | MN | Primary |
Addresses
Primary practice location
308 Brimhall St
Saint Paul, MN 55105-2430
Mailing address
308 Brimhall St
Saint Paul, MN 55105-2430
Phone (651) 698-8115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 188706-0 | Other | MN | MINNESOTA BOARD OF NURSING |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 188706-0 | MN | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301356800000",
"number": "1306135462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 BRIMHALL ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551052430",
"telephone_number": "651-698-8115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 BRIMHALL ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551052430",
"telephone_number": "651-698-8115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOIS",
"first_name": "JACQUES",
"middle_name": "DOMINIC",
"name_prefix": "Mr.",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-29",
"last_updated": "2011-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "MN",
"license": "188706-0",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA BOARD OF NURSING",
"identifier": "188706-0",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.