Individual provider Active NPI

Jennifer Stoffers, CNM

  • Advanced Practice Midwife
  • Maple Grove, MN
National Provider Identifier
1851378467
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R1472284 Issued in MN
Practice address
9825 Hospital Dr #205
Maple Grove, MN 55369
Phone
(763) 587-7000
Fax
(763) 587-7015
NPI assigned
Dec 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X R1472284 MN Primary

Addresses

Primary practice location

9825 Hospital Dr #205
Maple Grove, MN 55369

Mailing address

5700 Bottineau Blvd #210
Crystal, MN 55429
Phone (763) 587-7000

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000072 MN Practitioner - Certified Nurse Midwife (CNM) 7810066099 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1472284MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Premier OBGYN of Minnesota PLLC CurrentSince Jun 25, 2012 Accepting new patients
Park Nicollet Clinic CurrentSince May 5, 2010 Accepting new patients
Park Nicollet Clinic CurrentSince May 5, 2010 Accepting new patients
Maple Grove Hospital Corporation Past Accepting new patients
Metropolitan Obstetrics & Gynecology Past Accepting new patients

Locations

11855 Ulysses St NE
Ste 240
Blaine, MN 55434

9825 Hospital Dr
Ste 205
Maple Grove, MN 55369
Phone (763) 587-7000

5700 Bottineau Blvd
Ste 210
Minneapolis, MN 55429
Phone (763) 330-2774

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

15535 34th Ave N
Ste 200
Plymouth, MN 55447

3007 Harbor Ln N
Ste 1400
Plymouth, MN 55447
Phone (763) 587-7000

15535 34th Ave N
Plymouth, MN 55447
Phone (763) 581-5950

Interoperability endpoints

  • Direct secure messaging: jennifer.stoffers.1@20897.direct.athenahealth.com

Organizations & group practices 5

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1851378467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD #210",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "55429",
            "telephone_number": "763-587-7000",
            "fax_number": "763-587-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR #205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-587-7000",
            "fax_number": "763-587-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOFFERS",
        "first_name": "JENNIFER",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "R1472284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.