Mark Jheran Zabat Alvarez, RN

Key facts

NPI

1700644192

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

R53318 (ND)

Practice address

3131 34TH Ave S Apt 312
Fargo, ND 58104-5102

Phone

(701) 793-8278

NPI assigned

Mar 11, 2024

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

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 11, 2024.

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1700644192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 34TH AVE S APT 312",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045102",
            "telephone_number": "701-793-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 34TH AVE S APT 312",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045102",
            "telephone_number": "701-793-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "MARK JHERAN",
        "middle_name": "ZABAT",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R53318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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