Jordan R Lindholm, MD
Individual provider Active NPI Family Medicine Physician · Duluth, MN
NPI 1851914477 · NPPES record last updated Jun 26, 2023
Key facts
- NPI
- 1851914477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 69947 (MN)
- Practice address
- 1400 Woodland Ave
Duluth, MN 55803-2624 - Phone
- (218) 249-8800
- NPI assigned
- May 19, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 30
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of North Dakota School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Luke'S Hospital of Duluth
Polinsky Medical Rehabilitation Center
Practice addresses (Care Compare)
1400 Woodland Ave
Duluth, MN 55803-2624
Phone (218) 249-8800
1600 Miller Trunk Hwy
BLDG C
Duluth, MN 55811-5640
Phone (218) 786-5360
Hospital & facility affiliations
- Aspirus St. Luke'S at Home - Home Care - Duluth
- Aveanna Home Health
- Ecumen Home Care Lakeshore
- Aspirus St. Luke'S at Home-Hospice-Duluth
- St Lukes Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230831001186 | MN | Practitioner - Family Practice | 0648692483 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69947 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Luke'S Hospital of Duluth | Current |
Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current |
Accepting new patients | |
| St. Luke'S Hospital of Duluth | Family Medicine | Past | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
1400 Woodland Ave
Duluth, MN 55803
Phone (218) 249-8800
915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352
1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860
Interoperability endpoints
- jlindholm352078@direct.aspirus.org
- jordan.lindholm@slk.direct.slhduluth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 69947 | MN | Yes |
Addresses
Primary practice location
1400 Woodland Ave
Duluth, MN 55803-2624
Mailing address
1400 Woodland Ave
Duluth, MN 55803-2624
Phone (218) 249-8800
Other practice location 1
330 N 8th Ave E
Duluth, MN 55805-2024
Phone (218) 723-1112
Other providers in Duluth, MN
- Amelie Joann Lindberg-Livingston
- Kristen Ann Lindblom
- Marjorie Anne Lindemann
- Karen Lindgren
- Lori G W Lindgren
- Kristina Marie Lindholm
- David Andrew Lindlbauer
- Cody Lindquist
- Kimberly Ann Davis Lindquist
- Grace Caroline Lindstrom
All providers in Duluth, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.