Individual provider Active NPI

Jessica Ann Hurdelbrink Jones, PHD, LP

  • Clinical Psychologist
  • Fargo, ND
National Provider Identifier
1679873525
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
502 Issued in ND
Practice address
1126 Westrac Dr S
Fargo, ND 58103-2473
Phone
(701) 412-2973
Fax
(701) 237-4407
NPI assigned
Oct 26, 2010
Last updated
Feb 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP5545 MN
Clinical Psychologist 103TC0700X 502 ND Primary

Addresses

Primary practice location

1126 Westrac Dr S
Fargo, ND 58103-2473

Mailing address

891 Belsly Blvd Ste 100
Moorhead, MN 56560-5055
Phone (218) 287-4338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141103002548 ND Practitioner - Clinical Psychologist 8628220019 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Minnesota Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Becoming Balanced PCGroup PAC ID 3072845411, 7 clinicians

Practice addresses (Care Compare)

4610 Amber Valley Pkwy S
Suite E
Fargo, ND 58104-8621
Phone (701) 551-1840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Becoming Balanced PC CurrentSince Sep 20, 2022 Accepting new patients
Neuropsychology Associates, PA CurrentSince Aug 14, 2017 Accepting new patients

Locations

1220 Main Ave
Ste 100
Fargo, ND 58103
Phone (701) 297-7588

4610 Amber Valley Pkwy S
Ste E
Fargo, ND 58104
Phone (701) 551-1840

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.

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1679873525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 BELSLY BLVD STE 100",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605055",
            "telephone_number": "218-287-4338",
            "fax_number": "218-287-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 WESTRAC DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032473",
            "telephone_number": "701-412-2973",
            "fax_number": "701-237-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JESSICA",
        "middle_name": "ANN HURDELBRINK",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5545",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.