Active NPI
Justine Fosle, FNP-C
- Nurse Practitioner
- St Louis Park, MN
National Provider Identifier
1104661818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11803
- Practice address
- 2820 Inglewood Ave S
St Louis Park, MN 55416-4112 - Phone
- (914) 589-5503
- NPI assigned
- Jun 26, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 11803 | MN | Primary |
| Registered Nurse | 163W00000X | 2358271 | MN |
Addresses
Primary practice location
2820 Inglewood Ave S
St Louis Park, MN 55416-4112
Mailing address
5115 Excelsior Blvd Ste 712
Minneapolis, MN 55416-2906
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
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
St Louis Park, MN 55416
Phone (914) 589-5503
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Hospital & facility affiliations
- Essentia Health Duluth
- Essentia Health Deer River
- Essentia Health St Mary'S Medical Center
- Essentia Health Virginia
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2358271 | MN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD. | Current | Accepting new patients | |
| Provider Partners Care Management LP | Nurse Practitioner | Current | Accepting new patients |
| Aeris Medical Group PLLC | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Past | Accepting new patients |
Locations
8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
820 Lilac Dr N
Ste 140
Minneapolis, MN 55422
Phone (763) 465-0500
800 2nd Ave NW
Plainview, MN 55964
Phone (507) 534-3191
5115 Excelsior Blvd
St Louis Park, MN 55416
Phone (763) 753-2807
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- St Louis Park, MN
- NPI 1184228520
-
- Multi-Specialty Clinic/Center
- Cloquet, MN
- NPI 1902563638
-
- Multi-Specialty Clinic/Center
- Duluth, MN
- NPI 1245278209
-
- Community/Retail Pharmacy
- Hinckley, MN
- NPI 1245081066
-
- Anesthesiology Physician
- Duluth, MN
- NPI 1760417935
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital Clinic/Center
- Deer River, MN
- NPI 1518904887
-
- Critical Access Hospital Clinic/Center
- Grand Rapids, MN
- NPI 1093152423
-
- Medicare Defined Swing Bed Hospital Unit
- Deer River, MN
- NPI 1215041199
-
- Critical Access Hospital
- Deer River, MN
- NPI 1225049018
-
- General Acute Care Hospital
- Virginia, MN
- NPI 1083617120
-
- General Acute Care Hospital
- Duluth, MN
- NPI 1457393035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1104661818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5115 EXCELSIOR BLVD STE 712",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554162906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 INGLEWOOD AVE S",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554164112",
"telephone_number": "914-589-5503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSLE",
"first_name": "JUSTINE",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-26",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "11803",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "2358271",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.