NPIMap

Individual provider Active NPI

Jacqueline Ann Jorgenson

  • Nurse Practitioner
  • Baldwin, WI
National Provider Identifier
1689385577
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13391 Issued in WI
Practice address
1100 Bergslien St
Baldwin, WI 54002-2600
Phone
(715) 684-1553
Fax
(715) 684-1119
NPI assigned
Dec 12, 2022
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 13391 WI Primary
Registered Nurse 163W00000X 228561 WI

Addresses

Primary practice location

1100 Bergslien St
Baldwin, WI 54002-2600

Mailing address

1100 Bergslien St
Baldwin, WI 54002-2600
Phone (715) 684-1553

Other names 1

  • Jacqueline Wnuk Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjorgenson570343@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230302001660 WI Practitioner - Nurse Practitioner 6406229947 Reassigns benefits to 1 organization
I20241126000725 MN Practitioner - Nurse Practitioner 6406229947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

11475 Robinson Dr NW
Coon Rapids, MN 55433-3746
Phone (763) 754-0041

233 Radio Dr
Woodbury, MN 55125-5805
Phone (952) 967-7616

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
228561WIMDRegistered Nurse
13391WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Area Medical Center Inc. CurrentSince Jan 1, 2023 Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Baldwin Area Medical Center, Inc. Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Group Health Plan, Inc. CurrentSince Jan 6, 2025 Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

15290 Pennock Ln
Saint Paul, MN 55124
Phone (952) 431-8500

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

233 Radio Dr
Woodbury, MN 55125
Phone (651) 254-7400

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

Interoperability endpoints

  • Direct secure messaging: jjorgenson570343@excellian.direct.allina.com

Organizations & group practices 6

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 8

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1689385577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BERGSLIEN ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540022600",
            "telephone_number": "715-684-1553",
            "fax_number": "715-684-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BERGSLIEN ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540022600",
            "telephone_number": "715-684-1553",
            "fax_number": "715-684-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSON",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13391",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "228561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjorgenson570343@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1100 Bergslien St",
            "city": "Baldwin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540022600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "WNUK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baldwin, WI

Sources for this page

Verify at the official NPI Registry.