Individual provider Active NPI

Jena Marie Labine, NP

  • Family Nurse Practitioner
  • North Branch, MN
National Provider Identifier
1366893331
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R-166126-0 Issued in MN
Practice address
5366 386TH St NE
North Branch, MN 55056-5833
Phone
(651) 674-8868
NPI assigned
Jun 30, 2016
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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-166126-0 MN Primary

Addresses

Primary practice location

5366 386TH St NE
North Branch, MN 55056-5833

Mailing address

5366 386TH St NE
North Branch, MN 55056-5833
Phone (651) 674-8868

Other names 1

  • Jena Marie Peterson Former name

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160825001069 MN Practitioner - Nurse Practitioner 4082909353 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

18580 Joplin Ave
Lakeville, MN 55044-4218
Phone (952) 892-9555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-166126-0MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Aug 18, 2016 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Aug 18, 2016 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Aug 18, 2016 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Past Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

303 E Nicollet Blvd
Ste 160
Burnsville, MN 55337
Phone (952) 460-4000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

18580 Joplin Ave
Lakeville, MN 55044
Phone (952) 892-9500

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

5366 386th St NE
North Branch, MN 55056
Phone (651) 674-6800

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: jlabine60951@fairview.direct-ci.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 7

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1366893331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5366 386TH ST NE",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550565833",
            "telephone_number": "651-674-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5366 386TH ST NE",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550565833",
            "telephone_number": "651-674-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABINE",
        "first_name": "JENA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R-166126-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENA",
            "last_name": "PETERSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Branch, MN

Sources for this page

Verify at the official NPI Registry.