Individual provider Active NPI

Jessica Smolen, NP

  • Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1003477894
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R32606 Issued in ND
Practice address
321 8TH Ave N
Fargo, ND 58102-4550
Phone
(701) 234-2525
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R32606 ND Primary

Addresses

Primary practice location

321 8TH Ave N
Fargo, ND 58102-4550

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (701) 234-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190925000598 MN Practitioner - Nurse Practitioner 4486984093 Reassigns benefits to 1 organization
I20191106001301 ND Practitioner - Nurse Practitioner 4486984093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

321 8TH Ave N
Fargo, ND 58102-4550
Phone (701) 234-2525

4000 28TH Ave S
Moorhead, MN 56560-7926
Phone (701) 234-3200

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R32606NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Aug 12, 2019 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 12, 2019 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

737 Broadway N
Fargo, ND 58102
Phone (701) 234-4811

3955 56th St S
Ste D
Fargo, ND 58104
Phone (701) 234-2431

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

321 8th Ave N
Fargo, ND 58102
Phone (701) 234-2525

2601 Broadway N
Fargo, ND 58102
Phone (701) 234-2482

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1003477894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "701-234-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 8TH AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024550",
            "telephone_number": "701-234-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLEN",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R32606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.