Individual provider Active NPI

Jennifer Koehn, MSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1104282896
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15875 Issued in MN
Practice address
5861 Cedar Lake Rd S
Minneapolis, MN 55416-1653
Phone
(715) 208-0144
NPI assigned
Jan 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 15875 MN Primary

Addresses

Primary practice location

5861 Cedar Lake Rd S
Minneapolis, MN 55416-1653

Mailing address

5861 Cedar Lake Rd S
Minneapolis, MN 55416-1653
Phone (715) 208-0144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Access Healthcare Services, LLC Past Accepting new patients

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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1104282896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5861 CEDAR LAKE RD S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161653",
            "telephone_number": "715-208-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5861 CEDAR LAKE RD S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161653",
            "telephone_number": "715-208-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "JENNIFER",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.