Individual provider Active NPI

Jennifer Dubeau Bedard-Parker, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baxter, MN
National Provider Identifier
1396560801
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11914 Issued in MN
Practice address
13045 Falcon Dr Ste 100
Baxter, MN 56425-4201
Phone
(218) 829-9307
NPI assigned
Nov 19, 2024
Last updated
Jul 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11914 MN Primary

Addresses

Primary practice location

13045 Falcon Dr Ste 100
Baxter, MN 56425-4201

Mailing address

752 Grand Ave
Saint Paul, MN 55105-3306
Phone (651) 842-3003

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
I20250115003574 MN Practitioner - Nurse Practitioner 6800324070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

13045 Falcon Dr
Suite 100
Baxter, MN 56425-4201
Phone (218) 829-9307

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Jul 21, 2025 Accepting new patients
Huffman Institute Inc Psychiatric/Mental Health CurrentSince Dec 1, 2024 Accepting new patients
Family Support Services Inc. PastSince Jan 1, 2024 Accepting new patients

Locations

13045 Falcon Dr
#100
Brainerd, MN 56425
Phone (218) 203-6282

2785 White Bear Ave N
Ste 404
Maplewood, MN 55109
Phone (651) 447-7071

9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

752 Grand Ave
Ste 1
Saint Paul, MN 55105
Phone (651) 447-7071

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1396560801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053306",
            "telephone_number": "651-842-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13045 FALCON DR STE 100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564254201",
            "telephone_number": "218-829-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDARD-PARKER",
        "first_name": "JENNIFER",
        "middle_name": "DUBEAU",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "11914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

Verify at the official NPI Registry.