Jack Wyckoff
Individual provider Active NPI Personal Care Attendant · Richardton, ND
NPI 1538025564 · NPPES record last updated Feb 2, 2026
Key facts
- NPI
- 1538025564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 339 Wehrle Dr
Richardton, ND 58652-7105 - Phone
- (972) 757-0335
- NPI assigned
- Jan 3, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chore Provider | 372500000X | |||
| Personal Care Attendant | 3747P1801X | ND | Yes |
Addresses
Primary practice location
339 Wehrle Dr
Richardton, ND 58652-7105
Mailing address
339 Wehrle Dr
Richardton, ND 58652-7105
Other providers in Richardton, ND
All providers in Richardton, ND · Personal Care Attendant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.