Jacquelyn Haugen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R36541 Issued in ND

Practice address

1000 E Rosser Ave
Bismarck, ND 58501-4414

Phone

(701) 712-4500

NPI assigned

Jan 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacki Meyer Other name

Medicare fee-for-service enrollment

Enrolled in ND

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment Care Compare group NPD
• Mid Dakota Clinic, Inc.

  • Clinic/Center
  • Bismarck, ND
  • NPI 1275587826
  Medicare reassignment NPD
• Innovis Health LLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576
  NPD

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

• St. Alexius Medical Center

  • General Acute Care Hospital
  • Bismarck, ND
  • NPI 1306832654
  Care Compare affiliation

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1558022962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014506",
            "telephone_number": "701-712-4500",
            "fax_number": "701-712-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E ROSSER AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014414",
            "telephone_number": "701-712-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 E Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585014520",
            "country_code": "US",
            "telephone_number": "701-530-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R36541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKI",
            "last_name": "MEYER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Davin Hatlestad, M.D.
• Caitlin Hatzenbuhler
• Morgan Hauck
• Nicole Hauck
• Hannah Mae Hauff, PA-C
• Kenneth Haugen, PHARMD
• Stacey S Haugen, MSN, CS
• Wyniah Lyn Haugen, MS CCC-SLP
• Jennifer Hausauer
• Kari Hausauer

• Family Nurse Practitioner in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Family Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.