Active NPI
Jessica Larson, MD
- Pediatrics Physician
- Elk River, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 46376
- Practice address
- 290 Main St NW
Elk River, MN 55330-1270 - Phone
- (763) 241-5800
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 46376 | MN | Primary |
Addresses
Primary practice location
290 Main St NW
Elk River, MN 55330-1270
Mailing address
27060 136TH St
Zimmerman, MN 55398-9300
Other names 1
- Jessica Nicholson
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Past | Accepting new patients |
Locations
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
290 Main St NW
Elk River, MN 55330
Phone (763) 241-5800
290 Main St NW
Ste 100
Elk River, MN 55330
Phone (763) 241-0373
400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203
720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649
919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
Interoperability endpoints
- jlarson8329@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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Multi-Specialty Clinic/Center
- Fridley, MN
- NPI 1205017670
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
- Primary Care Clinic/Center
- Apple Valley, MN
- NPI 1649462508
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
- General Acute Care Hospital
- Princeton, MN
- NPI 1922085299
-
- Multi-Specialty Clinic/Center
- Maple Grove, MN
- NPI 1841315165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1477595536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27060 136TH ST",
"city": "ZIMMERMAN",
"state": "MN",
"postal_code": "553989300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 MAIN ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301270",
"telephone_number": "763-241-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "JESSICA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "46376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "NICHOLSON",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Elk River, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.