Individual provider Active NPI

Jennifer M Hanson, RN, NP

  • Adult Health Nurse Practitioner
  • Sisseton, SD
National Provider Identifier
1922236223
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R189007-3 Issued in MN
Practice address
205 Orchard Dr
Sisseton, SD 57262-2312
Phone
(605) 698-4665
Fax
(605) 698-6401
NPI assigned
Jun 24, 2009
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R189007-3 MN Primary
Registered Nurse 163W00000X R189007-3 MN

Addresses

Primary practice location

205 Orchard Dr
Sisseton, SD 57262-2312

Mailing address

PO Box 8674
1230 E. Main Street Mankato Clinic, LTD
Mankato, MN 56002-8674
Phone (507) 625-1811

Other practice location 1

1230 E. Main Street
Mankato Clinic at Main Street
Mankato, MN 56002-8674
Phone (507) 625-1811

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jenniferhanson@mklt.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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

Enrollment IDStateProvider typePAC IDDetails
I20250131001941 SD Practitioner - Nurse Practitioner 9537208145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coteau Des Prairies HospitalGroup PAC ID 8022926468, 11 clinicians

Practice addresses (Care Compare)

116 W Main St
Rosholt, SD 57260-2258
Phone (605) 537-4244

205 Orchard Dr
Sisseton, SD 57262-2312
Phone (605) 698-7647

205 Orchard Dr
Sisseton, SD 57262-2398

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R189007-3MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coteau Des Prairies Hospital CurrentSince Jan 16, 2025 Accepting new patients
Coteau Des Prairies Hospital Current Accepting new patients
Coteau Des Prairies Hospital CurrentSince Jan 16, 2025 Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1922236223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8674",
            "address_2": "1230 E. MAIN STREET MANKATO CLINIC, LTD",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560028674",
            "telephone_number": "507-625-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ORCHARD DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "572622312",
            "telephone_number": "605-698-4665",
            "fax_number": "605-698-6401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 E. Main Street",
            "address_2": "Mankato Clinic at Main Street",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560028674",
            "country_code": "US",
            "telephone_number": "507-625-1811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R189007-3",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R189007-3",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenniferhanson@mklt.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1230 E. Main Street",
            "address_2": "Mankato Clinic at Main Street",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560028674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sisseton, SD

Sources for this page

Verify at the official NPI Registry.