Active NPI
Anastasia Jellison
- Psychologist
- Bloomington, MN
National Provider Identifier
1891621868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 8017 3Rd Ave S
Bloomington, MN 55420-1215 - Phone
- (651) 359-5054
- NPI assigned
- Jun 18, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
8017 3Rd Ave S
Bloomington, MN 55420-1215
Mailing address
8017 3Rd Ave S
Bloomington, MN 55420-1215
Phone (651) 359-5054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781740800000",
"number": "1891621868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8017 3RD AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554201215",
"telephone_number": "651-359-5054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8017 3RD AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554201215",
"telephone_number": "651-359-5054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELLISON",
"first_name": "ANASTASIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-18",
"last_updated": "2026-06-18",
"certification_date": "2026-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.