Individual provider Active NPI

Jennifer Lynn Budd, DO

  • Family Medicine Physician
  • North Saint Paul, MN
National Provider Identifier
1083625057
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45676 Issued in MN
Practice address
2601 Centennial Dr
Suite 100
North Saint Paul, MN 55109-3086
Phone
(651) 777-7414
Fax
(651) 748-5839
NPI assigned
Aug 11, 2006
Last updated
Oct 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45676 MN Primary

Addresses

Primary practice location

2601 Centennial Dr
Suite 100
North Saint Paul, MN 55109-3086

Mailing address

2025 Sloan PL
Suite 35
Saint Paul, MN 55117-2007
Phone (651) 772-1572

Other identifiers 1

IdentifierTypeStateIssuer
423911300MedicaidMN

Other names 1

  • Jennifer Gardell Other 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050722000092 MN Practitioner - Family Practice 5092742981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

580 Rice St
Saint Paul, MN 55103-2148
Phone (651) 227-6551

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45676MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Nov 25, 2020 Accepting new patients
Healtheast St. John's Hospital CurrentSince Sep 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Nov 25, 2020 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

580 Rice St
Saint Paul, MN 55103
Phone (651) 227-6551

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: jbudd285861@fairview.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1083625057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL",
            "address_2": "SUITE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172007",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 CENTENNIAL DR",
            "address_2": "SUITE 100",
            "city": "NORTH SAINT PAUL",
            "state": "MN",
            "postal_code": "551093086",
            "telephone_number": "651-777-7414",
            "fax_number": "651-748-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDD",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "45676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423911300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GARDELL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.