Jill Renee Magnuson, MA, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3686 Issued in MN

Practice address

600 W 78TH St
Suite 220C
Chanhassen, MN 55317-9585

Phone

(612) 578-2530

Fax

(952) 400-5760

NPI assigned

Nov 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1386940005
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1801076351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 78TH ST",
            "address_2": "SUITE 220C",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179585",
            "telephone_number": "612-578-2530",
            "fax_number": "952-400-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 78TH ST",
            "address_2": "SUITE 220C",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179585",
            "telephone_number": "612-578-2530",
            "fax_number": "952-400-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSON",
        "first_name": "JILL",
        "middle_name": "RENEE",
        "credential": "MA, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Live Well Chiropractic Spa and Acupuncture Center
• Lisa Logelin
• Lucas Myeong-Kil Lund
• Luxealign PLLC
• Luxottica of America Inc.
• Carolyn C Majkrzak, PA-C
• Rebecca Angela Therese Manley, MA CCC-SLP
• Leigh Marasco, PT
• Katie Anne Mark, MSW, LICSW
• Douglas Martin

• Psychologist in Chanhassen, MN
• Providers in Chanhassen, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.