Individual provider Active NPI

Jennifer Minter

  • Nurse Practitioner
  • Rensselaer, IN
National Provider Identifier
1639565666
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71002930A Issued in IN
Practice address
118 W Drexel Pkwy
Rensselaer, IN 47978-7344
Phone
(219) 866-4300
Fax
(219) 866-7591
NPI assigned
Apr 7, 2015
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71002930A IN Primary

Addresses

Primary practice location

118 W Drexel Pkwy
Rensselaer, IN 47978-7344

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other identifiers 2

IdentifierTypeStateIssuer
815150022OtherINMEDICARE PTAN
201287460MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jminter111109@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150514002812 IN Practitioner - Nurse Practitioner 5698095644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

909 Sagamore Pkwy W
West Lafayette, IN 47906-1443
Phone (765) 463-6262

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71002930AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network Current Accepting new patients
Franciscan Physician Network CurrentSince Oct 1, 2016 Accepting new patients
Franciscan Physician Network CurrentSince Oct 1, 2016 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

1104 E Grace St
Rensselaer, IN 47978
Phone (219) 866-2026

118 W Drexel Pkwy
Rensselaer, IN 47978
Phone (219) 866-4300

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

909 Sagamore Pkwy W
West Lafayette, IN 47906
Phone (765) 463-5252

Interoperability endpoints

  • Direct secure messaging: jminter111109@direct.franciscanalliance.org

Organizations & group practices 3

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 2

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": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1639565666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 W DREXEL PKWY",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479787344",
            "telephone_number": "219-866-4300",
            "fax_number": "219-866-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTER",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71002930A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "815150022",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201287460",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jminter111109@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "118 W Drexel Pkwy",
            "city": "Rensselaer",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479787344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rensselaer, IN

Sources for this page

Verify at the official NPI Registry.