Individual provider Active NPI

Jessica Rebecca Dasher, NP

  • Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1689947491
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN138716 Issued in GA
Practice address
9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone
(912) 423-0396
NPI assigned
Feb 10, 2012
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 RN138716 GA Primary

Addresses

Primary practice location

9900 Bren Rd E
Minnetonka, MN 55343-9664

Mailing address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20151120001499 GA Practitioner - Nurse Practitioner 7618277799 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN138716GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Nurse Practitioner CurrentSince Sep 27, 2025 Accepting new patients
Community Care Health Network LLC Nurse Practitioner CurrentSince Nov 24, 2025 Accepting new patients
East Georgia Hma Physician Management, LLC Nurse Practitioner PastSince Nov 13, 2023 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684

7300 Lester Rd
Union City, GA 30291
Phone (770) 703-2604

Interoperability endpoints

  • Direct secure messaging: jessica.dasher.1@14940.direct.athenahealth.com

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": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1689947491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "912-423-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASHER",
        "first_name": "JESSICA",
        "middle_name": "REBECCA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2020-11-06",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN138716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.