Jordan Benson, NP
Individual provider Active NPI Obstetrics & Gynecology Nurse Practitioner · Brainerd, MN
NPI 1104126994 · NPPES record last updated Jan 7, 2016
Key facts
- NPI
- 1104126994
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner 363LX0001X
- License
- BER104357610 (MN)
- Practice address
- 2024 S 6TH St
Brainerd, MN 56401-3054 - Phone
- (218) 828-7100
- Fax
- (218) 828-7194
- NPI assigned
- Oct 26, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brainerd Medical Center Inc
St Josephs Medical Center
Practice addresses (Care Compare)
13060 Isle Dr
Baxter, MN 56425-8331
Phone (218) 454-5935
2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100
Hospital & facility affiliations
- Essentia Health St Joseph'S Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20110314001085 | MN | Practitioner - Nurse Practitioner | 1355523242 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 828847 | MN | MD | Obstetrics & Gynecology Nurse Practitioner |
| BER104357610 | MN | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brainerd Medical Center Inc | Current |
Accepting new patients | |
| St Joseph'S Medical Center | Current |
Accepting new patients | |
| Brainerd Medical Center Inc. | Current |
Accepting new patients | |
| Brainerd Medical Center Inc | Current | Accepting new patients | |
| St. Joseph'S Medical Center | Current | Accepting new patients | |
| St Joseph'S Medical Center | Current |
Accepting new patients | |
| St. Joseph'S Medical Center | Past | Accepting new patients |
Locations
523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394
523 N 3rd St
Ofc
Brainerd, MN 56401
Phone (218) 828-2880
13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920
2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 828847 | MN | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | BER104357610 | MN | Yes |
Addresses
Primary practice location
2024 S 6TH St
Brainerd, MN 56401-3054
Mailing address
523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861
Other providers in Brainerd, MN
- Megan KC Benedett
- Ross B Bengtson
- Valerie Ann Benjamin
- Anna Lyn Benson
- Charles Alan Benson
- Joseph Arlo Benson
- Stacey Ann Berent
- John C Berg
- Nicholas P Bernier
- Ralph Berry
All providers in Brainerd, MN · Obstetrics & Gynecology 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 Jan 7, 2016. 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.