Active NPI
Jessica A Norton, PAC
- Physician Assistant
- Elk River, MN
National Provider Identifier
1477585222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9673
- Practice address
- 19021 Freeport St NW
Suite 100
Elk River, MN 55330-1278 - Phone
- (763) 645-3313
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9673 | MN | Primary |
Addresses
Primary practice location
19021 Freeport St NW
Suite 100
Elk River, MN 55330-1278
Mailing address
19021 Freeport St NW
Suite 100
Elk River, MN 55330-1278
Phone (763) 645-3313
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 141285 | Other | UCARE | |
| 964851028877 | Other | P ONE | |
| 0120726 | Other | MEDICA | |
| 156615600 | Other | NEW MA PROVIDER NUMBER | |
| P00232858 | Other | RAILROAD MEDICARE | |
| 381K3RU | Other | BCBS | |
| 970002200 | Other | METRAHEALTH MPIN |
Other names 1
- Jessica A Rutzen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Three Rivers Pathology PA | Past | Accepting new patients |
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.
-
- Anatomic Pathology Physician
- Roseville, MN
- NPI 1003878661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388361600000",
"number": "1477585222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19021 FREEPORT ST NW",
"address_2": "SUITE 100",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301278",
"telephone_number": "763-645-3313",
"fax_number": "763-432-7544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19021 FREEPORT ST NW",
"address_2": "SUITE 100",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301278",
"telephone_number": "763-645-3313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTON",
"first_name": "JESSICA",
"middle_name": "A",
"credential": "PAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2013-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "141285",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "P ONE",
"identifier": "964851028877",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0120726",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW MA PROVIDER NUMBER",
"identifier": "156615600",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00232858",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "381K3RU",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METRAHEALTH MPIN",
"identifier": "970002200",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "RUTZEN",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
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- Joy Marie Notch, LMFT
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- Now Care Medical Centers
- Bradley John Nozzarella, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.