Individual provider Active NPI

Jennifer Connor, PHD LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1689739179
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
954 Issued in MN
Practice address
1300 S 2ND St Ste 180
Minneapolis, MN 55454-5000
Phone
(612) 625-1500
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 954 MN Primary

Addresses

Primary practice location

1300 S 2ND St Ste 180
Minneapolis, MN 55454-5000

Mailing address

1300 S 2ND St Ste 180
Minneapolis, MN 55454-5000
Phone (612) 625-1500

Other identifiers 4

IdentifierTypeStateIssuer
62-56533OtherMNMEDICA PROVIDER NUMBER
HP63279OtherMNHEALTHPARTNERS PROVIDER#
601R7COOtherMNBCBS PROVIDER NUMBER
110169200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240116002634 MN Practitioner - Marriage and Family Therapist 1557713526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

1300 S 2ND St
Suite 180
Minneapolis, MN 55454-5000
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians CurrentSince Jan 1, 2024 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2024 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2024 Accepting new patients

Locations

1300 S 2nd St
Ste 180
Minneapolis, MN 55454
Phone (612) 625-1500

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

Organizations & group practices 5

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1689739179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S 2ND ST STE 180",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554545000",
            "telephone_number": "612-625-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S 2ND ST STE 180",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554545000",
            "telephone_number": "612-625-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "JENNIFER",
        "credential": "PHD LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PROVIDER NUMBER",
            "identifier": "62-56533",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS PROVIDER#",
            "identifier": "HP63279",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "601R7CO",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110169200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.