NPIMap

Individual provider Active NPI

Jennifer Rose Tomford, APRN-FNP

  • Family Nurse Practitioner
  • Melrose, MN
National Provider Identifier
1346727211
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6018 Issued in MN
Practice address
525 Main St W
Melrose, MN 56352-1043
Phone
(320) 256-4228
NPI assigned
Jul 24, 2018
Last updated
Jul 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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 6018 MN Primary

Addresses

Primary practice location

525 Main St W
Melrose, MN 56352-1043

Mailing address

525 Main St W
Melrose, MN 56352-1043

Other names 1

  • Jennifer Rose Theiler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180907001267 MN Practitioner - Nurse Practitioner 6103176417 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

525 Main St W
Melrose, MN 56352-1043
Phone (320) 256-4231

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6018MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health-Paynesville LLC CurrentSince Nov 1, 2019 Accepting new patients
Centracare Health System - Long Prairie CurrentSince Nov 1, 2019 Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Nov 1, 2019 Accepting new patients
Cura of Sauk Centre LLC CurrentSince Nov 1, 2019 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Nov 1, 2019 Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients
Centracare Health-Paynesville LLC Current Accepting new patients
Centracare Health System - Melrose CurrentSince Sep 1, 2018 Accepting new patients
Centracare Health System - Melrose CurrentSince Sep 1, 2018 Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients

Locations

50 Centracare Dr
Long Prairie, MN 56347
Phone (320) 732-2131

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

Interoperability endpoints

  • Direct secure messaging: jtomford414387@direct.centracare.com

Organizations & group practices 10

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 11

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": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1346727211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 MAIN ST W",
            "city": "MELROSE",
            "state": "MN",
            "postal_code": "563521043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 MAIN ST W",
            "city": "MELROSE",
            "state": "MN",
            "postal_code": "563521043",
            "telephone_number": "320-256-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMFORD",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "APRN-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "THEILER",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Melrose, MN

Sources for this page

Verify at the official NPI Registry.