Individual provider Active NPI

Jennifer Kathryn Nelson, PT

  • Orthopedic Physical Therapist
  • Eagan, MN
National Provider Identifier
1174581755
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
8072 Issued in MN
Practice address
2620 Eagan Woods Dr Ste 200
Eagan, MN 55121-1138
Phone
(651) 968-5201
NPI assigned
May 3, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 8072 MN Primary

Addresses

Primary practice location

2620 Eagan Woods Dr Ste 200
Eagan, MN 55121-1138

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080818000679 MN Practitioner - Physical Therapist in Private Practice 0547354201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

2620 Eagan Woods Dr
Eagan, MN 55121-1138
Phone (651) 968-5201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics, LTD. CurrentSince Jun 2, 2008 Accepting new patients
Summit Orthopedics, LTD Orthopedic Current Accepting new patients
Summit Orthopedics LTD CurrentSince Jun 2, 2008 Accepting new patients
Spinal Designs International Past Accepting new patients
Buckeye 96 LP Orthopedic PastSince Oct 10, 2014 Accepting new patients

Locations

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5335

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 271-1592

2620 Eagan Woods Dr
Ste 200
Saint Paul, MN 55121
Phone (651) 968-5230

3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5770

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5600

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174581755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5042",
            "fax_number": "651-968-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EAGAN WOODS DR STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211138",
            "telephone_number": "651-968-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JENNIFER",
        "middle_name": "KATHRYN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MN",
            "license": "8072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.