Individual provider Active NPI

Jodi Lynn Misegades, RN PHN

  • Community Health Registered Nurse
  • New York Mills, MN
National Provider Identifier
1811123573
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
R152074-1 Issued in MN
Practice address
118 Main Avenue North
New York Mills, MN 56567-0099
Phone
(218) 385-5508
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R152074-1 MN Primary

Addresses

Primary practice location

118 Main Avenue North
New York Mills, MN 56567-0099

Mailing address

PO Box 99
New York Mills, MN 56567-0099
Phone (218) 385-5508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R152074-1MNMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Otter Tail County Public Health Past Accepting new patients
Otter Tail County Auditor Past Accepting new patients

Organizations & group practices 2

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": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1811123573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565670099",
            "telephone_number": "218-385-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAIN AVENUE NORTH",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565670099",
            "telephone_number": "218-385-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISEGADES",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "credential": "RN PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MN",
            "license": "R152074-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York Mills, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.