Individual provider Active NPI

Jenni Lynn Mincoff, APRN, FNP

  • Family Nurse Practitioner
  • Rice Lake, WI
National Provider Identifier
1821598715
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2103028 Issued in MN
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, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009001937 WI Practitioner - Nurse Practitioner 8123380219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8524WIMDPharmacist
2103028MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Specialists of Wisconsin, SC CurrentSince Oct 22, 2019 Accepting new patients
Interventional Pain Specialists of Wisconsin, SC CurrentSince Oct 22, 2019 Accepting new patients
Prevea Clinic, Inc. Past Accepting new patients
North Memorial Health Care PastSince Apr 1, 2018 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.

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

Verify at the official NPI Registry.