NPIMap

Individual provider Active NPI

Jodi M Nicholson, PA-C

  • Medical Physician Assistant
  • Alexandria, MN
National Provider Identifier
1922078344
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9998 Issued in MN
Practice address
1527 Broadway St
Alexandria, MN 56308-2537
Phone
(320) 762-0399
Fax
(320) 762-6847
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9998 MN Primary

Addresses

Primary practice location

1527 Broadway St
Alexandria, MN 56308-2537

Mailing address

1527 Broadway St
Alexandria, MN 56308-2537
Phone (320) 762-0399

Other identifiers 6

IdentifierTypeStateIssuer
318G2NIOtherMNBLUE SHIELD
A029OtherMNCHAMPUS
2360626OtherMNAMERICA'S PPO
HP53165OtherMNHEALTH PARTNERS
0121310OtherMNMEDICA
1043861OtherMNPREFERRED ONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000113 MN Practitioner - Physician Assistant 4486695582 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians
Curana Health of Minnesota PLLCGroup PAC ID 6305233461, 62 clinicians

Practice addresses (Care Compare)

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

1527 Broadway St
Alexandria, MN 56308-2537
Phone (320) 762-0399

5123 W 98TH St
Suite 2082
Minneapolis, MN 55437-2040
Phone (737) 226-6700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3381GAMDMental Health Counselor
9998MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Sep 1, 2022 Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 1, 2022 Accepting new patients
First Medical Care Inc PastSince Sep 1, 2018 Accepting new patients

Locations

1527 Broadway St
Alexandria, MN 56308
Phone (320) 762-0399

115 E Soo St
Parkers Prairie, MN 56361
Phone (218) 338-4371

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922078344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 BROADWAY ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082537",
            "telephone_number": "320-762-0399",
            "fax_number": "320-762-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 BROADWAY ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082537",
            "telephone_number": "320-762-0399",
            "fax_number": "320-762-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JODI",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "9998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "318G2NI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "A029",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "2360626",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP53165",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0121310",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1043861",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.