Jaci Rae Hannasch, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8803 Issued in MN

Practice address

300 S Bruce St
Marshall, MN 56258-1934

Phone

(507) 532-9661

NPI assigned

Dec 2, 2021

Last updated

Jan 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jaci Rae Pronk Former name

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera MarshallGroup PAC ID 5799695227, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera Marshall Regional Medical Ctr Hospital, Marshall, MN, CCN 241359
• Avera Granite Falls Hospital, Granite Falls, MN, CCN 241343

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

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.

• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Medicare reassignment Care Compare group NPD
• Avera Marshall

  dba Avera Medical Group Carlson

  • Multi-Specialty Clinic/Center
  • Marshall, MN
  • NPI 1407330301
  NPD
• Avera Marshall

  dba Avera Medical Group Optometry - Marshall

  • Optometrist
  • Marshall, MN
  • NPI 1487422465
  NPD
• Avera Marshall

  dba Avera Marshall Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Marshall, MN
  • NPI 1962641936
  NPD (past)
• Granite Falls Municipal Hospital and Manor

  • Critical Access Hospital
  • Granite Falls, MN
  • NPI 1780654962
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Avera Granite Falls

  dba Avera Granite Falls Health Center

  • Critical Access Hospital
  • Granite Falls, MN
  • NPI 1700429610
  Care Compare affiliation
• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Care Compare affiliation

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1760140180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 MERCEDES DR",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562585497",
            "telephone_number": "605-360-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S BRUCE ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581934",
            "telephone_number": "507-532-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNASCH",
        "first_name": "JACI",
        "middle_name": "RAE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACI",
            "last_name": "PRONK",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gloria Haag
• Jennifer Haedrich
• Mary Arndt Hagan, M.D.
• Dana A Hamilton, PT
• Elizabeth Lynn Hankermeyer, LPCC
• Austin Ray Hansen
• Benjamin Larry Hanson, DDS
• Karissa J Hanson
• Bridgit Harris
• Donna Rae Hartfiel, M.D.

• Nurse Practitioner in Marshall, MN
• Providers in Marshall, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.