Individual provider Active NPI

Jessica Lynn Schilling, PH.D., LP

  • Psychologist
  • Duluth, MN
National Provider Identifier
1720121486
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP4762 Issued in MN
Practice address
530 E 2ND St
Essentia Health Polinksy Medical Rehab Center
Duluth, MN 55805-1913
Phone
(218) 786-5360
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP4762 MN Primary

Addresses

Primary practice location

530 E 2ND St
Essentia Health Polinksy Medical Rehab Center
Duluth, MN 55805-1913

Mailing address

530 E 2ND St
Essentia Health Polinsky Medical Rehab Center
Duluth, MN 55805-1913
Phone (218) 786-5360

Other names 1

  • Jessica Wolf Former name

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
I20070510000586 MN Practitioner - Clinical Psychologist 6002912854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duluth Graduate Medical Education Council IncGroup PAC ID 4385545953, 32 clinicians

Practice addresses (Care Compare)

330 N 8TH Ave E
Duluth, MN 55805-2024
Phone (218) 723-1112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP4762MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Duluth Graduate Medical Education Council Inc CurrentSince Sep 13, 2021 Accepting new patients
Polinsky Medical Rehabilitation Center CurrentSince Aug 5, 2015 Accepting new patients
SMDC Medical Center Past Accepting new patients
Deer River Healthcare Center, Inc. Past Accepting new patients

Locations

530 E 2nd St
Duluth, MN 55805
Phone (218) 786-5300

330 N 8th Ave E
Duluth, MN 55805
Phone (218) 529-9122

1600 Miller Trunk Hwy
Bldg C
Duluth, MN 55811
Phone (218) 786-5360

Organizations & group practices 4

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1720121486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E 2ND ST",
            "address_2": "ESSENTIA HEALTH POLINSKY MEDICAL REHAB CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-786-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E 2ND ST",
            "address_2": "ESSENTIA HEALTH POLINKSY MEDICAL REHAB CENTER",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-786-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILLING",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PH.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WOLF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.