Individual provider Active NPI

Jennifer Bunders, MSW, LICSW

  • Clinical Social Worker
  • Coon Rapids, MN
National Provider Identifier
1295202182
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25537 Issued in MN
Practice address
9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone
(763) 780-9155
NPI assigned
Oct 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 25537 MN Primary

Addresses

Primary practice location

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841

Mailing address

4969 Olson Memorial Hwy
Golden Valley, MN 55422-5138
Phone (763) 575-8086

Other practice location 1

4969 Olson Memorial Hwy
Golden Valley, MN 55422-5138
Phone (763) 575-8086 ext. 16

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbunders582088@excellian.direct.allina.com Direct

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200401001275 MN Practitioner - Clinical Social Worker 6800225525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System CurrentSince Apr 18, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Apr 18, 2022 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

Interoperability endpoints

  • Direct secure messaging: jbunders582088@excellian.direct.allina.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1295202182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4969 OLSON MEMORIAL HWY",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225138",
            "telephone_number": "763-575-8086",
            "fax_number": "320-774-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335841",
            "telephone_number": "763-780-9155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4969 Olson Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554225138",
            "country_code": "US",
            "telephone_number": "763-575-8086 x16",
            "fax_number": "320-774-0415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNDERS",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbunders582088@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "9055 Springbrook Dr NW",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554335841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.