Individual provider Active NPI

Reannin Des Jarlais, CNP

  • Family Nurse Practitioner
  • Edina, MN
National Provider Identifier
1841026531
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11817 Issued in MN
Practice address
3400 W 66TH St Ste 385
Edina, MN 55435-2197
Phone
(952) 927-6561
NPI assigned
Sep 10, 2024
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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 11817 MN Primary

Addresses

Primary practice location

3400 W 66TH St Ste 385
Edina, MN 55435-2197

Mailing address

3400 W 66TH St Ste 385
Edina, MN 55435-2197
Phone (952) 737-8268

Other practice location 1

2805 Campus Dr Ste 315
Plymouth, MN 55441-2679
Phone (763) 577-7460

Other names 1

  • Reannin Foltz Former name

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
I20241107001851 MN Practitioner - Nurse Practitioner 2769916154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

3400 W 66TH St
Suite 240
Edina, MN 55435-2100
Phone (952) 857-0304

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Nov 1, 2024 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Nov 1, 2024 Accepting new patients
Adefris & Toppin Women's Specialists,MDPC Past Accepting new patients

Locations

3400 W 66th St
Ste 240
Edina, MN 55435
Phone (952) 857-0304

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

Organizations & group practices 3

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": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1841026531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 385",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352197",
            "telephone_number": "952-737-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 385",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352197",
            "telephone_number": "952-927-6561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2805 Campus Dr Ste 315",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554412679",
            "country_code": "US",
            "telephone_number": "763-577-7460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DES JARLAIS",
        "first_name": "REANNIN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REANNIN",
            "last_name": "FOLTZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.