Individual provider Active NPI

Jennifer Hayes, PA-C

  • Physician Assistant
  • Grand Forks, ND
National Provider Identifier
1548812704
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0790 Issued in ND
Practice address
1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone
(701) 795-2000
Fax
(701) 795-2260
NPI assigned
Jul 9, 2019
Last updated
Sep 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0790 ND Primary

Addresses

Primary practice location

1380 S Columbia Rd
Grand Forks, ND 58201-4059

Mailing address

725 Hamline St
Grand Forks, ND 58203-2819
Phone (701) 780-6400

Other names 1

  • Jennifer Christianson Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jchristianson95780@direct.directaltru.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191217001887 ND Practitioner - Physician Assistant 6901230481 Reassigns benefits to 1 organization
I20230306002317 MN Practitioner - Physician Assistant 6901230481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1001 7TH St NE
Devils Lake, ND 58301-2719
Phone (701) 662-2157

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000

725 Hamline St
Grand Forks, ND 58203-2819
Phone (701) 780-6800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAC0790NDMDPhysician Assistant
13143MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Sep 23, 2019 Accepting new patients
Altru Health System CurrentSince Sep 23, 2019 Accepting new patients
Altru Health System Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

607 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-0357

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

725 Hamline St
Grand Forks, ND 58203
Phone (701) 777-6800

Interoperability endpoints

  • Direct secure messaging: jchristianson95780@direct.directaltru.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1548812704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 HAMLINE ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582032819",
            "telephone_number": "701-780-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014059",
            "telephone_number": "701-795-2000",
            "fax_number": "701-795-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchristianson95780@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "Direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1380 S Columbia Rd",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "582014059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CHRISTIANSON",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.