Active NPI
Grace Jepchirchir Fidalgo, RN
- Foster Care Agency
- Cottage Grove, MN
National Provider Identifier
1730722745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foster Care Agency
- License
- 1099897
- Practice address
- 6222 Hedgecroft Ave S
Cottage Grove, MN 55016-6002 - Phone
- (612) 859-8250
- Fax
- (651) 330-5351
- NPI assigned
- Oct 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 2441890 | MN | |
| Home Health Aide | 374U00000X | |||
| Foster Care Agency | 253J00000X | 1099897 | MN | Primary |
Addresses
Primary practice location
6222 Hedgecroft Ave S
Cottage Grove, MN 55016-6002
Mailing address
6222 Hedgecroft Ave S
Cottage Grove, MN 55016-6002
Phone (612) 859-8250
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | jep257chirchir@yahoo.com | Health Information Exchange (HIE) |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2441890 | MN | MD | Home Health Registered Nurse |
| 1099897 | MN | MD | Foster Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649721600000",
"number": "1730722745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6222 HEDGECROFT AVE S",
"city": "COTTAGE GROVE",
"state": "MN",
"postal_code": "550166002",
"telephone_number": "612-859-8250",
"fax_number": "651-330-5351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6222 HEDGECROFT AVE S",
"city": "COTTAGE GROVE",
"state": "MN",
"postal_code": "550166002",
"telephone_number": "612-859-8250",
"fax_number": "651-330-5351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIDALGO",
"first_name": "GRACE",
"middle_name": "JEPCHIRCHIR",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-22",
"last_updated": "2022-04-12",
"certification_date": "2022-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "MN",
"license": "2441890",
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": "MN",
"license": "1099897",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "jep257chirchir@yahoo.com",
"affiliation": "N",
"endpointDescription": "Business email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "business email",
"address_1": "6222 Hedgecroft Ave S",
"city": "Cottage Grove",
"state": "MN",
"country_code": "US",
"postal_code": "550166002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cottage Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.