Jennifer Elizabeth Boyd, CNP

Key facts

NPI: 1487992913
Entity type: Individual (NPI type 1)
Primary specialty: Pediatric Nurse Practitioner 363LP0200X
License: 20121792 (MN)
Practice address: Pediatrics 1415 St Francis Ave
Park Nicollet Clinic-Shakopee
Shakopee, MN 55379
Phone: (952) 993-7781
NPI assigned: Jan 17, 2013
Sex: Female
Sole proprietor: No

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.

Park Nicollet Clinic Family Medicine Physician · St Louis Park, MN · NPI 1780621904

Medicare reassignment NPD MN

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MN
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20130508000567	MN	Practitioner - Nurse Practitioner	2163669235	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Certified Nurse Practitioner, Nurse Practitioner

State licenses

License	State	Type	Specialty
20121792	MN	MD	Pediatric Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Park Nicollet Clinic		Current	Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

1415 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 993-7750

Interoperability endpoints

Direct secure messaging: jboyd153138@direct.healthpartners.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatric Nurse Practitioner	363LP0200X	20121792	MN	Yes

Addresses

Primary practice location

Pediatrics 1415 St Francis Ave
Park Nicollet Clinic-Shakopee
Shakopee, MN 55379

Mailing address

Pediatrics 1415 St Francis Ave
Park Nicollet Clinic-Shakopee
Shakopee, MN 55379

Other providers in Shakopee, MN

Kasie Lynn Bondeson
Sarah E Bordeleau, LPCC
Cara Leanne Borggren, D.C.;
Natalie Rose Borrell
Kimberly C Bourassa, DNP, APRN, PMHNP-BC
Marquitta Crystal Braih, APRN
Harley Jean Brake Walker
Jamie Brandell
Hilary Breedon, NP
Teresa L Brenke

All providers in Shakopee, MN · Pediatric Nurse Practitioner in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.