Individual provider Active NPI

Adrianna Jensen

  • Family Nurse Practitioner
  • Fairmont, MN
National Provider Identifier
1376796763
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2905 Issued in MN
Practice address
800 Medical Center Dr
Fairmont, MN 56031
Phone
(507) 238-8100
NPI assigned
Oct 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2905 MN Primary
Family Nurse Practitioner 363LF0000X 1681075 MN
Family Nurse Practitioner 363LF0000X APN001089 NV

Addresses

Primary practice location

800 Medical Center Dr
Fairmont, MN 56031

Mailing address

800 Medical Center Dr
Fairmont, MN 56031-4575
Phone (507) 238-8100

Other practice location 1

920 2nd Ave S
Suite 400
Minneapolis, MN 55402-3318
Phone (612) 225-1512

Other practice location 2

920 2nd Ave S
Suite 400
Minneapolis, MN 55402-3318
Phone (612) 225-1512

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajensen87702@ehrdirect.mayoclinicmsg.org

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
I20090922000296 MN Practitioner - Nurse Practitioner 8729143193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Medical Ctr Dr
Fairmont, MN 56031-4575
Phone (507) 238-8555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1681075MNMDFamily Nurse Practitioner
APN001089NVMDFamily Nurse Practitioner

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1376796763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "56031",
            "telephone_number": "507-238-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 2nd Ave S",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554023318",
            "country_code": "US",
            "telephone_number": "612-225-1512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 2nd Ave S",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554023318",
            "country_code": "US",
            "telephone_number": "612-225-1512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "ADRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2905",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "1681075",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APN001089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajensen87702@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "800 Medical Center Dr",
            "city": "Fairmont",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairmont, MN

Sources for this page

Verify at the official NPI Registry.