Kelley L Jensen, APRN, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP6987 Issued in MN

Practice address

1542 Golf Course Rd Ste 204
Grand Rapids, MN 55744-3537

Phone

(218) 999-7000

NPI assigned

Aug 9, 2019

Last updated

Oct 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Professionals, PAGroup PAC ID 4587753934, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bigfork Valley Hospital Hospital, Bigfork, MN, CCN 241316
• Grand Itasca Clinic and Hospital Hospital, Grand Rapids, MN, CCN 240064

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13291/brand/1/csg/1/fhir/r4
• Direct secure messaging: kljensen@dermpro.emadirect.md

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.

• Dermatology Professionals, PA

  • Clinic/Center
  • Baxter, MN
  • NPI 1720269426
  Medicare reassignment Care Compare group NPD
• Deer River Healthcare Center, Inc.

  dba Essentia Health Deer River

  • Critical Access Hospital
  • Deer River, MN
  • NPI 1225049018
  Medicare reassignment NPD
• Dermatology Professionals PA

  • Clinic/Center
  • Saint Cloud, MN
  • NPI 1720840788
  NPD
• Dermatology Professionals, PA

  • MOHS-Micrographic Surgery Physician
  • Grand Rapids, MN
  • NPI 1467169979
  NPD
• Cromwell Medical Clinic PLLC

  • Primary Care Clinic/Center
  • Cromwell, MN
  • NPI 1821250549
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Care Compare affiliation Name & address match
• Northern Itasca Hospital District

  dba Bigfork Valley Hospital

  • Critical Access Hospital
  • Bigfork, MN
  • NPI 1851335525
  Care Compare affiliation

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1477108033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD STE 204",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443537",
            "telephone_number": "218-999-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KELLEY",
        "middle_name": "L",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP6987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Hill Psychological Services L.L.C
• Brittany Jacobson
• Lana Rae Jacobson, FAMILY NURSE PRACTIT
• James Rostvold (West Range Dental Care)
• Jason Jarvis, LPCC
• Lee Dale Jess, D.D.S.
• John L Bonner Eye Clinic LTD
• Amber L. Johnson, CRNA
• David Johnson, RPH
• James Frederick Johnson, D.D.S.

• Family Nurse Practitioner in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.