Individual provider Active NPI

Jenifer Flegel

  • Pediatric Nurse Practitioner
  • West Saint Paul, MN
National Provider Identifier
1538691043
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CNP 5078 Issued in MN
Practice address
963 Robert St S
West Saint Paul, MN 55118-1446
Phone
(651) 726-9500
NPI assigned
Apr 3, 2017
Last updated
Aug 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X CNP 5078 MN Primary

Addresses

Primary practice location

963 Robert St S
West Saint Paul, MN 55118-1446

Mailing address

963 South Robert Street
West Saint Paul, MN 55118-1446

Other practice location 1

1804 7th St W Ste 200
Saint Paul, MN 55116-2300
Phone (651) 256-6714

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191115001344 MN Practitioner - Nurse Practitioner 3375975139 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP 5078MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Clinic Network CurrentSince Oct 8, 2019 Accepting new patients
Children's Clinic Network CurrentSince Oct 8, 2019 Accepting new patients
Metropolitan Pediatric Specialists, P.a. Past Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

1547 Livingston Ave
West St Paul, MN 55118
Phone (651) 451-8050

963 Robert St S
West St Paul, MN 55118
Phone (651) 726-9500

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1538691043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 SOUTH ROBERT STREET",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551181446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 ROBERT ST S",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551181446",
            "telephone_number": "651-726-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1804 7th St W Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551162300",
            "country_code": "US",
            "telephone_number": "651-256-6714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLEGEL",
        "first_name": "JENIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "CNP 5078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.