Jennifer Alma Wilson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP 4189 Issued in MN

Practice address

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Phone

(952) 993-3400

Fax

(952) 993-3286

NPI assigned

Jan 24, 2016

Last updated

Apr 13, 2023By 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 2

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilson268226@excellian.direct.allina.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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1912315144
  NPD
• Fairview Pharmacy Services LLC

  dba Fairview Richfield Medical Clinic MTM RMG

  • Non-Pharmacy Dispensing Site
  • Richfield, MN
  • NPI 1295178135
  NPD (past)

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

• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1174980692
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  dba Park Nicollet Methodist Hospital Outpatient Surgery Center

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1194113217
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  dba PN Methodist Hospital Episodic Bundle

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1245615772
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  dba Park Nicollet Melrose Center

  • Mental Illness Community Based Residential Treatment Facility
  • St Louis Park, MN
  • NPI 1578717336

  Hospital

  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1649220724
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  dba Park Nicollet Melrose Center

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1942585286
  Care Compare affiliation

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

{
    "created_epoch": "1453593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1902263866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3400",
            "fax_number": "952-993-3286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Osborne Rd NE",
            "address_2": "Suite 255",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554322774",
            "country_code": "US",
            "telephone_number": "763-786-6011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "ALMA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-24",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 200885-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 4189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilson268226@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "500 Osborne Rd NE",
            "address_2": "Suite 255",
            "city": "Fridley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554322774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittany Joy Willis, OTR/L
• David John Willis, MD
• Christa M Willits
• Anthony Wilson
• Ashley Marie Wilson, PA-C
• Jennifer Windsor
• Molly M Wingert
• Terence Wingert
• Holly Winters, PSYD LP
• Brittany E Wirth, DPT

• Family Nurse Practitioner in St Louis Park, MN
• Providers in St Louis Park, 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 Apr 13, 2023; 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.