NPIMap

Individual provider Active NPI

Jessica McClure, PA-C

  • Physician Assistant
  • Coon Rapids, MN
National Provider Identifier
1477112316
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14348 Issued in MN
Practice address
11850 Blackfoot St NW Ste 130
Coon Rapids, MN 55433-2583
Phone
(763) 236-9000
Fax
(763) 236-9010
NPI assigned
Jun 12, 2019
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14348 MN Primary

Addresses

Primary practice location

11850 Blackfoot St NW Ste 130
Coon Rapids, MN 55433-2583

Mailing address

PO Box 206
Minneapolis, MN 55480-0206
Phone (612) 262-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230425001916 MN Practitioner - Physician Assistant 6800228388 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14348MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Oct 29, 2025 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 31, 2023 Accepting new patients
Allina Health System CurrentSince May 5, 2025 Accepting new patients
Group Health, Inc. Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 31, 2023 Accepting new patients
Group Health, Inc. CurrentSince Oct 29, 2025 Accepting new patients
Allina Health System CurrentSince May 5, 2025 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

11850 Blackfoot St NW
Ste 130
Minneapolis, MN 55433
Phone (763) 236-2045

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

Interoperability endpoints

  • Direct secure messaging: jmcclure777364@fairview.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1477112316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554800206",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 130",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332583",
            "telephone_number": "763-236-9000",
            "fax_number": "763-236-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.