Individual provider Active NPI

Jody Michelle Schoenecker, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1386951358
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2010008194 Issued in MN
Practice address
615 1St Ave NE Ste 310
Minneapolis, MN 55413-2419
Phone
(612) 436-0295
Fax
(612) 436-0163
NPI assigned
Sep 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1241826 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2010008194 MN Primary

Addresses

Primary practice location

615 1St Ave NE Ste 310
Minneapolis, MN 55413-2419

Mailing address

615 1St Ave NE Ste 310
Minneapolis, MN 55413-2419
Phone (612) 436-0295

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jschoenecker8557@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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240610001352 MN Practitioner - Nurse Practitioner 6305169392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

615 1St Ave NE
Suite 310
Minneapolis, MN 55413-2419

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1241826MNMDNurse Practitioner
2010008194MNMDPsychiatric/Mental Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jschoenecker8557@excellian.direct.allina.com

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": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1386951358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 1ST AVE NE STE 310",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132419",
            "telephone_number": "612-436-0295",
            "fax_number": "612-436-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 1ST AVE NE STE 310",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132419",
            "telephone_number": "612-436-0295",
            "fax_number": "612-436-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENECKER",
        "first_name": "JODY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "1241826",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "2010008194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jschoenecker8557@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "701 Dellwood St S",
            "city": "Cambridge",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550081920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.