Individual provider Active NPI

Jeannie Michelle Campe, NP

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1114476512
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4838 Issued in MN
Practice address
333 Washington Ave N
Minneapolis, MN 55401-2263
Phone
(612) 873-2232
NPI assigned
Sep 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R1935776 MN
Family Nurse Practitioner 363LF0000X 4838 MN Primary

Addresses

Primary practice location

333 Washington Ave N
Minneapolis, MN 55401-2263

Mailing address

5108 W 104TH St
Minneapolis, MN 55437-2513
Phone (507) 317-5556

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170130001084 MN Practitioner - Nurse Practitioner 5395027262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Lyn-Lake Psychotherapy and Wellness LTDGroup PAC ID 9638581291, 72 clinicians

Practice addresses (Care Compare)

621 W Lake St
Suite 350
Minneapolis, MN 55408-2952
Phone (612) 979-2276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4838MNMDChiropractor
R1935776MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. CurrentSince Mar 1, 2022 Accepting new patients

Locations

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

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": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1114476512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 W 104TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554372513",
            "telephone_number": "507-317-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 WASHINGTON AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012263",
            "telephone_number": "612-873-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPE",
        "first_name": "JEANNIE",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R1935776",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "4838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.