Active NPI
Jolene Schlegel, CNP
- Nurse Practitioner
- Willmar, MN
National Provider Identifier
1063798379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- F0711128
- Practice address
- 502 2ND St SW Ste 1
Willmar, MN 56201-3365 - Phone
- (320) 235-7232
- Fax
- (320) 231-8602
- NPI assigned
- Nov 1, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F0711128 | MN | Primary |
Addresses
Primary practice location
502 2ND St SW Ste 1
Willmar, MN 56201-3365
Mailing address
502 2ND St SW Ste 1
Willmar, MN 56201-3365
Phone (320) 235-7232
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120301000913 | MN | Practitioner - Nurse Practitioner | 2668631193 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Amy R Ellingson MD PA
Practice addresses (Care Compare)
1037 19TH Ave SW
Willmar, MN 56201-5005
Phone (320) 214-1100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F0711128 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amy R Ellingson MD PA | Current | Accepting new patients |
Locations
1037 19th Ave SW
Willmar, MN 56201
Phone (320) 214-1100
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360281600000",
"number": "1063798379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 2ND ST SW STE 1",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562013365",
"telephone_number": "320-235-7232",
"fax_number": "320-231-8602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 2ND ST SW STE 1",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562013365",
"telephone_number": "320-235-7232",
"fax_number": "320-231-8602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHLEGEL",
"first_name": "JOLENE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-01",
"last_updated": "2013-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "F0711128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Willmar, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.