Individual provider Active NPI

Jennifer Kaye Mills, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1578424511
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
332068 Issued in AZ
Practice address
3674 S Washington St
Grand Forks, ND 58201-5766
Phone
(701) 205-3000
Fax
(701) 732-2501
NPI assigned
Nov 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 332068 AZ Primary

Addresses

Primary practice location

3674 S Washington St
Grand Forks, ND 58201-5766

Mailing address

PO Box 5210
Grand Forks, ND 58206-5210
Phone (701) 205-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, ND, MN, TX, AK5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20260302000135 AZ Practitioner - Nurse Practitioner 9537641477 Reassigns benefits to 1 organization
I20260330002980 ND Practitioner - Nurse Practitioner 9537641477 Reassigns benefits to 1 organization
I20260407003529 MN Practitioner - Nurse Practitioner 9537641477 Reassigns benefits to 1 organization
I20260515003286 TX Practitioner - Nurse Practitioner 9537641477 Reassigns benefits to 1 organization
I20260522000149 AK Practitioner - Nurse Practitioner 9537641477 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peterson Medical Clinics LLCGroup PAC ID 9335412220, 91 clinicians

Practice addresses (Care Compare)

Phoenix, AZ 85027
Phone (701) 205-3000

205 E Benson Blvd
Suite 401
Anchorage, AK 99503-4019
Phone (701) 205-3000

3674 S Washington St
Grand Forks, ND 58201-5766
Phone (701) 205-3000

519 Anne St NW
Suite a
Bemidji, MN 56601-4277
Phone (701) 205-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
332068AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Medical Clinics, LLC Psychiatry CurrentSince Feb 1, 2026 Accepting new patients

Locations

205 E Benson Blvd
Ste 401
Anchorage, AK 99503

519 Anne St NW
Ste A
Bemidji, MN 56601
Phone (218) 444-5700

4501 15th Ave SW
Ste 105
Fargo, ND 58103

3674 S Washington St
Grand Forks, ND 58201
Phone (701) 732-2538

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1763510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1578424511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5210",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582065210",
            "telephone_number": "701-205-3000",
            "fax_number": "701-732-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3674 S WASHINGTON ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015766",
            "telephone_number": "701-205-3000",
            "fax_number": "701-732-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "JENNIFER",
        "middle_name": "KAYE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-19",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "332068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.