Provider Home Care

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PROVIDER HOME CARE

Practice address

114 E Indiana Ave
Bismarck, ND 58504-5769

Phone

(701) 202-8033

NPI assigned

Apr 26, 2024

Last updated

May 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Enoch Nweyada, MR. ENOCH NWEYADA

Title

Owner

Phone

(701) 202-8033

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1720834195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E INDIANA AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045769",
            "telephone_number": "701-202-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E INDIANA AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045769",
            "telephone_number": "701-202-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "NWEYADA",
        "authorized_official_first_name": "ENOCH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-202-8033",
        "authorized_official_credential": "MR. ENOCH NWEYADA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.