Individual provider Active NPI

Jessica Marie Daniels, CNP, APRN

  • Nurse Practitioner
  • Saint Cloud, MN
National Provider Identifier
1699416974
Registry record updated Apr 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F02220290 Issued in MN
Practice address
1200 6TH Ave N
Saint Cloud, MN 56303-2736
Phone
(320) 252-2700
NPI assigned
Apr 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2022

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 F02220290 MN Primary

Addresses

Primary practice location

1200 6TH Ave N
Saint Cloud, MN 56303-2736

Mailing address

2100 Frederic CT
Sartell, MN 56377-5500
Phone (515) 447-1568

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718000595 MN Practitioner - Nurse Practitioner 0648651067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1200 6TH Ave N
St Cloud, MN 56303-2735
Phone (320) 252-5131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F02220290MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
Centracare Clinic CurrentSince Jun 1, 2022 Accepting new patients
Centracare Clinic CurrentSince Jun 1, 2022 Accepting new patients

Locations

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

Interoperability endpoints

  • Direct secure messaging: jdaniels617577@direct.centracare.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648857600000",
    "number": "1699416974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 FREDERIC CT",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563775500",
            "telephone_number": "515-447-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032736",
            "telephone_number": "320-252-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "CNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-02",
        "last_updated": "2022-04-02",
        "certification_date": "2022-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "F02220290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.