Debra Jane Sandbeck

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

1475694 Issued in ND

Practice address

2717 11TH Ave N
Fargo, ND 58102-3107

Phone

(701) 367-5837

NPI assigned

Dec 18, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1356937726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 11TH AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023107",
            "telephone_number": "701-367-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 11TH AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023107",
            "telephone_number": "701-367-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBECK",
        "first_name": "DEBRA",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "ND",
            "license": "1475694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1475694",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mail.google.com/mail/",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "EMAIL",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CORRESPONDENCE",
            "address_1": "2717 11th Ave N",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581023107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mail.google.com/mail/",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CORRESPONDENCE",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FILES",
            "address_1": "2717 11th Ave N",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581023107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Bridget Sanderson
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• In Home Supportive Care Agency in Fargo, ND
• Providers in Fargo, ND by specialty
• In Home Supportive Care Agency in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.