Chris Jensen LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

332292 Issued in MN

Legal business name

CHRIS JENSEN LLC

Practice address

2501 Rice Lake Rd
Duluth, MN 55811-4819

Phone

(218) 625-6411

Fax

(218) 625-6452

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Erin Shvetzoff Hennessey

Title

Manager

Phone

(763) 537-5700

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Chris Jensen Health & Rehabilition Center Doing business as

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1245387372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 WHITEWATER DR STE 201",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553439407",
            "telephone_number": "763-537-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 RICE LAKE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114819",
            "telephone_number": "218-625-6411",
            "fax_number": "218-625-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS JENSEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "HENNESSEY",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "SHVETZOFF",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "763-537-5700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "332292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "NH0143",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "9764CH",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175040200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7100488",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chris Jensen Health & Rehabilition Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chris Jensen Health & Rehabilition Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Vernon Chmielewski, MD
• Sara Beth Chmielewski, PT
• David M Choquette, MD
• Chris Jensen
• Chris Jensen Health & Rehab
• Coleen Rose Christensen, APRN-CNP
• Krista Nalani Christensen
• Mariah Sinclair Christensen, PA-C
• Michael Dean Christensen, PA-C
• Jacob Christenson

• Skilled Nursing Facility in Duluth, MN
• Providers in Duluth, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.