Jennifer A McLellan, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

61061 Issued in WI

Practice address

610 E Taylor St
Prairie Du Chien, WI 53821-2109

Phone

(608) 326-6466

NPI assigned

Jul 8, 2007

Last updated

Mar 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, CO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

University of Colorado School of Medicine, Denver, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Estes Park Medical Center Hospital, Estes Park, CO, CCN 061312

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memorial Hospital of Boscobel

  dba Gundersen Boscobel Area Hospital and Clinics

  • Critical Access Hospital
  • Boscobel, WI
  • NPI 1760459846
  Medicare reassignment NPD
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864
  Medicare reassignment NPD
• Uchealth Estes Valley Medical Center

  dba Estes Park Health

  • Critical Access Hospital
  • Estes Park, CO
  • NPI 1154312981
  Medicare reassignment NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  Medicare reassignment
• Rural Physicians Group-Pannu PLLC

  • Hospitalist Physician
  • Greenwood Village, CO
  • NPI 1891236584
  Medicare reassignment
• Gundersen Clinic LTD

  dba Gundersen Pharmacy

  • Community/Retail Pharmacy
  • La Crosse, WI
  • NPI 1548710627
  NPD
• Memorial Hospital of Boscobel

  • Medicare Defined Swing Bed Hospital Unit
  • Boscobel, WI
  • NPI 1497712624
  NPD
• Tri-County Memorial Hospital, Inc.

  • Clinic/Center
  • Independence, WI
  • NPI 1073335642
  NPD
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Blair, WI
  • NPI 1659625192
  NPD
• Rural Physicians Group - Pannu PLLC

  • Hospitalist Physician
  • Sterling, CO
  • NPI 1417538539
  NPD
• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909

  Surgery

  NPD (past)

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

• Uchealth Estes Valley Medical Center

  dba Estes Park Health

  • Critical Access Hospital
  • Estes Park, CO
  • NPI 1154312981
  Care Compare affiliation

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

{
    "created_epoch": "1183852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1164620480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E TAYLOR ST",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538212109",
            "telephone_number": "608-326-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLELLAN",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-08",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301090378",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "250712",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "41119",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "61061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole D Martin, SLP
• Samantha Martin, MSW, CAPSW
• Kevin Dale Mathis, PHARMD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc. (Mayo Clinic Health System - Franciscan Healthcare Prairie du Chien)
• Jeffrey McDonald
• Tamara McReynolds, S.L.P
• Christopher J Mees, MD
• Michelle Mertens-Dodgen, ARNP
• Kristen Mezera, PT, DPT
• Laura Elizabeth Moerer

• Surgery Physician in Prairie Du Chien, WI
• Providers in Prairie Du Chien, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.

Verify at the official NPI Registry.