Jacob Klug, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

6683 Issued in MN

Practice address

512 Skyline Blvd
Cloquet, MN 55720-3787

Phone

(218) 879-4641

NPI assigned

Jul 15, 2019

Last updated

Nov 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Memorial Hospital AssociationGroup PAC ID 0042129991, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hisdept@direct.cloquethospital.com

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.

• Community Memorial Hospital Association

  • Critical Access Hospital
  • Cloquet, MN
  • NPI 1003869082
  Medicare reassignment Care Compare group NPD

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

• Community Memorial Hospital Association

  • Critical Access Hospital
  • Cloquet, MN
  • NPI 1003869082
  Care Compare affiliation

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1689226185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203787",
            "telephone_number": "218-879-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUG",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hisdept@direct.cloquethospital.com",
            "affiliation": "N",
            "address_1": "512 Skyline Blvd",
            "city": "Cloquet",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557203787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laurie L Kelley
• Patrick Joseph Kelley, PTA
• Charles Martin Kendall, MD
• Kathryn Rose Kensrud, PA-C
• Asma Khan, M.D.
• Carl Kolpin
• Kirsten Marie Kortesma, NP
• Lynne M Kosmach, NP, CDE
• Alexis M Kostek
• Mary Jo Koszarek, NP

• Nurse Practitioner in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.