Individual provider Active NPI

Jennifer Anne Senn

  • Physician Assistant
  • Grand Rapids, MN
National Provider Identifier
1831719459
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13634 Issued in MN
Practice address
1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone
(218) 326-3401
NPI assigned
Apr 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13634 MN Primary

Addresses

Primary practice location

1601 Golf Course Rd
Grand Rapids, MN 55744-8648

Mailing address

12175 88TH Ave NE
Deer River, MN 56636-2748
Phone (612) 280-6834

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210915001873 MN Practitioner - Physician Assistant 5496151565 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Practice addresses (Care Compare)

111 SE 3Rd St
Grand Rapids, MN 55744-3663
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone (218) 326-3401

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13634MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. CurrentSince Sep 7, 2021 Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
Essentia Health Moose Lake CurrentSince Mar 13, 2023 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Apr 1, 2023 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Interoperability endpoints

  • Direct secure messaging: jsenn772269@fairview.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1831719459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12175 88TH AVE NE",
            "city": "DEER RIVER",
            "state": "MN",
            "postal_code": "566362748",
            "telephone_number": "612-280-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 GOLF COURSE RD",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557448648",
            "telephone_number": "218-326-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENN",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

Verify at the official NPI Registry.