Individual provider Active NPI

Jessica Blackford, DNP, FNP-BC

  • Family Nurse Practitioner
  • Hudson, WI
National Provider Identifier
1346624319
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R-184602-7 Issued in MN
Practice address
403 Stageline Rd
Hudson, WI 54016-7848
Phone
(715) 531-6800
Fax
(715) 531-6801
NPI assigned
Jul 19, 2015
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R-184602-7 MN Primary

Addresses

Primary practice location

403 Stageline Rd
Hudson, WI 54016-7848

Mailing address

403 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6800

Other names 1

  • Jessica Voltmer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150805009281 MN Practitioner - Nurse Practitioner 4981918869 Reassigns benefits to 1 organization
I20160420000788 WI Practitioner - Nurse Practitioner 4981918869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Physicians SCGroup PAC ID 2668607557, 62 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Hudson, WI 54016-9914
Phone (715) 531-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-184602-7MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Physicians, S.C. CurrentSince Jan 9, 2017 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Group Health, Inc. Current Accepting new patients
Hudson Physicians, S.C. CurrentSince Jan 9, 2017 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Hudson Physicians, S.C. Past Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
Stillwater, MN 55082

840 Spruce St
Baldwin, WI 54002
Phone (715) 235-4274

2651 Hillcrest Dr
Hudson, WI 54016
Phone (630) 632-2648

2651 Hillcrest Dr
Ste 303
Hudson, WI 54016

403 Stageline Rd
Hudson, WI 54016
Phone (715) 386-8880

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1437264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1346624319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 STAGELINE RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167848",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 STAGELINE RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167848",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKFORD",
        "first_name": "JESSICA",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-19",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R-184602-7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "VOLTMER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.