Individual provider Active NPI

Ebrima Jarju

  • Driver
  • Madison, WI
National Provider Identifier
1639940869
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
726 Milky Way
Madison, WI 53718-2920
Phone
(608) 598-7849
Fax
(608) 467-6668
NPI assigned
Jan 16, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X WI Primary

Addresses

Primary practice location

726 Milky Way
Madison, WI 53718-2920

Mailing address

726 Milky Way
Madison, WI 53718-2920
Phone (608) 598-7849

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

Practice roles

OrganizationSpecialtyStatusNew patients
E & a Adult Family Home LLC Milky Way CurrentSince Dec 22, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1639940869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 MILKY WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182920",
            "telephone_number": "608-598-7849",
            "fax_number": "608-467-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 MILKY WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182920",
            "telephone_number": "608-598-7849",
            "fax_number": "608-467-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARJU",
        "first_name": "EBRIMA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.