Individual provider Active NPI

Jennifer Wilhelmy, CPNP

  • Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1164504767
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R1290343 Issued in MN
Practice address
200 University Ave E
Saint Paul, MN 55101-2507
Phone
(651) 325-2121
Fax
(651) 325-2122
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R1290343 MN Primary

Addresses

Primary practice location

200 University Ave E
Saint Paul, MN 55101-2507

Mailing address

200 University Ave E
Saint Paul, MN 55101-2507
Phone (651) 325-2121

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
I20040525000555 MN Practitioner - Nurse Practitioner 2163339987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1421 Premier Dr
Suite 100
Mankato, MN 56001-6076
Phone (507) 207-2700

200 University Ave E
Saint Paul, MN 55101-2507
Phone (651) 291-2848

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 636-9443

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1070MNMDMidwife
R1290343MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children'S Specialty Healthcare CurrentSince Jan 1, 2004 Accepting new patients
Gillette Children'S Specialty Healthcare CurrentSince Jan 1, 2004 Accepting new patients
Gillette Children'S Specialty Healthcare Past Accepting new patients

Locations

9550 Upland Ln N
Ste 220
Maple Grove, MN 55369
Phone (612) 902-8595

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1164504767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507",
            "telephone_number": "651-325-2121",
            "fax_number": "651-325-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507",
            "telephone_number": "651-325-2121",
            "fax_number": "651-325-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELMY",
        "first_name": "JENNIFER",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R1290343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.