Individual provider Active NPI

Jennifer Landry, LGSW

  • Social Worker
  • Eagan, MN
National Provider Identifier
1740970342
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3459 Washington Dr Ste 102
Eagan, MN 55122-1388
Phone
(608) 219-5244
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3459 Washington Dr Ste 102
Eagan, MN 55122-1388

Mailing address

7 Barton Ave SE Apt 1
Minneapolis, MN 55414-3541
Phone (608) 219-5244

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
I20260402001478 MN Practitioner - Clinical Social Worker 7113402520

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Minnesota Medical School, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4243 4TH Ave S
Minneapolis, MN 55409-2113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1740970342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BARTON AVE SE APT 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143541",
            "telephone_number": "608-219-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 WASHINGTON DR STE 102",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221388",
            "telephone_number": "608-219-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "JENNIFER",
        "credential": "LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.