Individual provider Active NPI

Jenna Herman, DNP, FNP, APRN

  • Family Nurse Practitioner
  • Arden Hills, MN
National Provider Identifier
1558659086
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R39399 Issued in ND
Practice address
4001 Lexington Ave N
Arden Hills, MN 55126
Phone
(701) 530-7000
NPI assigned
Jul 19, 2011
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 R1978476 MN
Family Nurse Practitioner 363LF0000X R39399 ND Primary

Addresses

Primary practice location

4001 Lexington Ave N
Arden Hills, MN 55126

Mailing address

4001 Lexington Ave N
Arden Hills, MN 55126
Phone (651) 375-2273

Other identifiers 1

IdentifierTypeStateIssuer
1451316MedicaidND

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
I20240715002781 MN Order and Referring Only - Nurse Practitioner 0446421390

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1978476MNMDFamily Nurse Practitioner
R39399NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carrington Health Center Past Accepting new patients
Marathon Health, LLC PastSince Mar 12, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jenna.herman.1@14940.direct.athenahealth.com

Organizations & group practices 2

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1558659086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 LEXINGTON AVE N",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "55126",
            "telephone_number": "651-375-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LEXINGTON AVE N",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "55126",
            "telephone_number": "701-530-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "JENNA",
        "credential": "DNP, FNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1978476",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R39399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1451316",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arden Hills, MN

Sources for this page

Verify at the official NPI Registry.