Jessica Mae Vanderhagen, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R147910-6 Issued in MN

Practice address

10 4TH Ave SE
Glenwood, MN 56334-1820

Phone

(320) 634-4521

Fax

(320) 634-2262

NPI assigned

Aug 4, 2006

Last updated

Jan 15, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

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 2

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, shared by 7 NPIs, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glacial Ridge Hospital Hospital, Glenwood, MN, CCN 241376

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c
• Direct secure messaging: jvanderhagen619341@direct.centracare.com

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.

• Centracare Clinic

  dba CentraCare - River Campus Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1043212665
  Medicare reassignment NPD
• Glacial Ridge Hospital District

  dba Brooten Medical Center

  • Family Medicine Physician
  • Brooten, MN
  • NPI 1255348223
  Medicare reassignment NPD
• Centracare Clinic

  dba CentraCare Occupations Health

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD
• Centracare Clinic

  dba CentraCare - Albany Clinic

  • Multi-Specialty Clinic/Center
  • Albany, MN
  • NPI 1457726549
  NPD
• Glacial Ridge Hospital District

  dba Starbuck Medical Center

  • Rural Health Clinic/Center
  • Starbuck, MN
  • NPI 1063952026
  NPD
• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  NPD
• CCM Health

  • Critical Access Hospital
  • Montevideo, MN
  • NPI 1720086028
  NPD (past)
• Centracare Clinic

  dba CentraCare - Plaza Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD (past)
• Glacial Ridge Hospital District

  dba Glacial Ridge Homecare

  • Home Health Agency
  • Glenwood, MN
  • NPI 1922017052
  NPD (past)

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

• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  Care Compare affiliation

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1871501734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 4TH AVE SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341820",
            "telephone_number": "320-634-4521",
            "fax_number": "320-634-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 4TH AVE SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341820",
            "telephone_number": "320-634-4521",
            "fax_number": "320-634-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHAGEN",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R147910-6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua David Thomas, D.O.
• Jodie Louise Trill, RN
• Trumm Drug, Inc. (Trumm Drug Glenwood)
• Trumm Drug, Inc. (Trumm Drug Glenwood)
• Unity Recovery LLC
• Vandesteeg & Larson Optometric Clinic PA (Glacial Ridge Eye Clinic)
• Vandesteeg & Larson Optometric Clinic, PA (Glacial Ridge Eye Clinic)
• Amanda Volesky, PT, DPT
• Nikki Wait
• Tayler Waldvogel, M.S. LADC, LPCC

• Family Nurse Practitioner in Glenwood, MN
• Providers in Glenwood, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.