Active NPI
Jenni Lynn Mincoff, APRN, FNP
- Family Nurse Practitioner
- Rice Lake, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2103028
- Practice address
- 2021 Cenex Dr Unit J
Rice Lake, WI 54868-1892 - Phone
- (715) 234-7246
- NPI assigned
- Feb 16, 2018
- Last updated
- Apr 21, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2103028 | MN | Primary |
Addresses
Primary practice location
2021 Cenex Dr Unit J
Rice Lake, WI 54868-1892
Mailing address
2021 Cenex Dr Unit J
Rice Lake, WI 54868-1892
Phone (715) 234-7246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181009001937 | WI | Practitioner - Nurse Practitioner | 8123380219 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8524 | WI | MD | Pharmacist |
| 2103028 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interventional Pain Specialists of Wisconsin, SC | Current | Accepting new patients | |
| Interventional Pain Specialists of Wisconsin, SC | Current | Accepting new patients | |
| Prevea Clinic, Inc. | Past | Accepting new patients | |
| North Memorial Health Care | Past | Accepting new patients |
Locations
401 Stageline Rd
Ste 2
Hudson, WI 54016
Phone (715) 234-7246
411 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000
2021 Cenex Dr
Unit J
Rice Lake, WI 54868
Phone (715) 234-7246
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pain Medicine (Anesthesiology) Physician
- Rice Lake, WI
- NPI 1649141060
-
- Pain Medicine (Anesthesiology) Physician
- Rice Lake, WI
- NPI 1992800791
-
- Internal Medicine Physician
- Green Bay, WI
- NPI 1306869276
-
dba North Memorial Health Specialty Clinic
- Medical Specialty Clinic/Center
- Robbinsdale, MN
- NPI 1871927715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745193600000",
"number": "1821598715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2021 CENEX DR UNIT J",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548681892",
"telephone_number": "715-234-7246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2021 CENEX DR UNIT J",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548681892",
"telephone_number": "715-234-7246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINCOFF",
"first_name": "JENNI",
"middle_name": "LYNN",
"credential": "APRN, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-16",
"last_updated": "2025-04-21",
"certification_date": "2025-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "2103028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rice Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.