Active NPI
Alex Nyangau, LPN
- Personal Care Attendant
- Moorhead, MN
National Provider Identifier
1952127649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- L18288
- Practice address
- 1518 34TH Ave S
Moorhead, MN 56560-6965 - Phone
- (206) 396-0842
- NPI assigned
- Nov 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | L18288 | ND | Primary |
Addresses
Primary practice location
1518 34TH Ave S
Moorhead, MN 56560-6965
Mailing address
1518 34TH Ave S
Moorhead, MN 56560-6965
Phone (206) 396-0842
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L18288 | ND | MD | Personal Care Attendant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maa Enterprise LLC | Current | 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.
-
- In Home Supportive Care Agency
- Fargo, ND
- NPI 1699658849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1952127649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1518 34TH AVE S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565606965",
"telephone_number": "206-396-0842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1518 34TH AVE S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565606965",
"telephone_number": "206-396-0842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYANGAU",
"first_name": "ALEX",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-26",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "ND",
"license": "L18288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.