Fidele Mutara

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

FID-92-9833

Practice address

615 10TH St NE Apt 203
Jamestown, ND 58401-3422

Phone

(701) 809-2090

NPI assigned

Oct 22, 2024

Last updated

Oct 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Legacy of Hope LLC

  • Foster Care Agency
  • Jamestown, ND
  • NPI 1629886312
  NPD Authorized official

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1952122095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 10TH ST NE APT 203",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013422",
            "telephone_number": "701-809-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 10TH ST NE APT 203",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013422",
            "telephone_number": "701-809-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTARA",
        "first_name": "FIDELE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": "FID-92-9833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Etienne Muraze Muragizi
• Dorothy L Murchie, LPN
• Dustin Murray
• Larissa A Musgrave, LRD
• Amber Muske
• Jessica Lynn Myers
• Sandra Myers
• Mikayla Joy Nahinurk
• Navigate Recovery PLLC
• Mike Ndayishimiye

• Nurse's Aide in Jamestown, ND
• Providers in Jamestown, ND by specialty
• Nurse's Aide in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.