Individual provider Active NPI

Jane Esther Allen, CPNP

  • Pediatric Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1043286743
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
90033 Issued in MN
Practice address
347 North Smith Avenue
Mail Stop #70-302, Garden View Medical Building
St. Paul, MN 55102
Phone
(651) 220-5230
Fax
(651) 220-5231
NPI assigned
Feb 23, 2006
Last updated
Jun 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X R1084685 MN
Pediatric Nurse Practitioner 363LP0200X 90033 MN Primary

Addresses

Primary practice location

347 North Smith Avenue
Mail Stop #70-302, Garden View Medical Building
St. Paul, MN 55102

Mailing address

347 North Smith Avenue
Mail Stop #70-302, Garden View Medical Building
St. Paul, MN 55102
Phone (651) 220-5230

Other names 1

  • Jane Esther Ellefson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051130000777 MN Practitioner - Nurse Practitioner 3971523390 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1084685MNMDPediatric Registered Nurse
90033MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Health Care CurrentSince Jun 9, 2013 Accepting new patients
Childrens Health Care CurrentSince Jun 9, 2013 Accepting new patients
Childrens Health Care Current Accepting new patients
Wayzata Children's Clinic P.a. PastSince Sep 17, 2010 Accepting new patients

Locations

18432 Kenrick Ave
Lakeville, MN 55044
Phone (952) 992-6700

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

347 Smith Ave N
Stop 70302
Saint Paul, MN 55102
Phone (651) 220-5230

628 Bielenberg Dr
Woodbury, MN 55125
Phone (612) 874-1292

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1043286743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 NORTH SMITH AVENUE",
            "address_2": "MAIL STOP #70-302, GARDEN VIEW MEDICAL BUILDING",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-220-5230",
            "fax_number": "651-220-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 NORTH SMITH AVENUE",
            "address_2": "MAIL STOP #70-302, GARDEN VIEW MEDICAL BUILDING",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-220-5230",
            "fax_number": "651-220-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JANE",
        "middle_name": "ESTHER",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MN",
            "license": "R1084685",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "90033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "ELLEFSON",
            "middle_name": "ESTHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.