Jaclyn Anne Marie Barney, APRN, CNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Duluth, MN
NPI 1104022573 · NPPES record last updated Aug 10, 2021
Key facts
- NPI
- 1104022573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 157580-30 (WI)
- Practice address
- 502 E 2ND St
Duluth, MN 55805-1913 - Phone
- (218) 786-8364
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- The Duluth Clinic LTD
Practice addresses (Care Compare)
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Hospital & facility affiliations
- Essentia Health Duluth
- St Marys Hospital Superior
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070920000204 | WI | Practitioner - Nurse Practitioner | 6406940501 | Reassigns benefits to 1 organization |
| I20110131000296 | MN | Practitioner - Nurse Practitioner | 6406940501 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 164377-0 | MN | MD | Family Nurse Practitioner |
| 157580-30 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Mary'S Duluth Clinic Health System | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Current |
Accepting new patients | |
| St. Mary'S Hospital of Superior | Current | Accepting new patients | |
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| The Duluth Clinic LTD | Current | Accepting new patients | |
| St. Mary'S Hospital of Superior | Current |
Accepting new patients |
Locations
200 Bunker Hill Dr
Aitkin, MN 56431
Phone (218) 927-2121
417 Skyline Blvd
Cloquet, MN 55720
Phone (218) 879-1271
502 E 2nd St
Duluth, MN 55805
Phone (218) 727-8762
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R 164377-0 | MN | |
| Family Nurse Practitioner | 363LF0000X | 157580-30 | WI | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 157580-30 | WI | Yes |
Addresses
Primary practice location
502 E 2ND St
Duluth, MN 55805-1913
Mailing address
400 East Third Street
Duluth, MN 55805-1951
Phone (218) 786-8364
Other practice location 1
3500 Tower Avenue
Superior, WI 54880-5335
Phone (715) 395-5454
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007200270 | Medicaid | WI |
Other providers in Duluth, MN
- Zachary Thomas Barclay
- Sarah Ann Bard
- Jean Marie Baribeau-Thoennes
- Racheal Jo Barnaal
- Cecelia Barnes
- Maren Elizabeth Barootian
- Emma J Barr
- Robin Barrett
- Stephanie Lyn Barta
- Megan Livingston Barthels
All providers in Duluth, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.