Individual provider Active NPI

Jamie Jones, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Buffalo, MN
National Provider Identifier
1548651409
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3630 Issued in MN
Practice address
30 1St Ave NE Ste 7
Buffalo, MN 55313-1515
Phone
(763) 400-8177
Fax
(304) 301-3047
NPI assigned
Feb 13, 2015
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP3630 MN
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X 3630 MN Primary

Addresses

Primary practice location

30 1St Ave NE Ste 7
Buffalo, MN 55313-1515

Mailing address

30 1St Ave NE Ste 7
Buffalo, MN 55313-1515
Phone (763) 400-8177

Other practice location 1

9201 Quaday Ave NE Ste 205
Otsego, MN 55330-6604
Phone (763) 400-8177

Other identifiers 1

IdentifierTypeStateIssuer
411952112OtherMNTAX ID

Other names 1

  • Jamie J Anderson Former name

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
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intentional Wellness Solutions CurrentSince Jan 12, 2020 Accepting new patients

Locations

30 1st Ave NE
Ste 7
Buffalo, MN 55313
Phone (763) 400-8177

121 Adams St S
Cambridge, MN 55008
Phone (763) 442-4111

9201 Quaday Ave NE
Ste 205
Otsego, MN 55330
Phone (763) 309-1005

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, 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": "1423785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1548651409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 1ST AVE NE STE 7",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131515",
            "telephone_number": "763-400-8177",
            "fax_number": "304-301-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 1ST AVE NE STE 7",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131515",
            "telephone_number": "763-400-8177",
            "fax_number": "304-301-3047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9201 Quaday Ave NE Ste 205",
            "address_purpose": "LOCATION",
            "city": "Otsego",
            "state": "MN",
            "postal_code": "553306604",
            "country_code": "US",
            "telephone_number": "763-400-8177",
            "fax_number": "304-301-3047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "JAMIE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-13",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP3630",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "3630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "411952112",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "ANDERSON",
            "middle_name": "J",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buffalo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.