Jennifer Renee Signor, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

67050 Issued in MN

Practice address

15111 Twelve Oaks Center Dr
Minnetonka, MN 55305-5202

Phone

(952) 993-4500

NPI assigned

Apr 10, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Renee Becker Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904

  Pediatrics

  Medicare reassignment NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593

  Pediatrics

  NPD
• Park Nicollet Methodist Hospital

  dba Park Nicollet Methodist Hospital Outpatient Surgery Center

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1194113217
  NPD

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1972036531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15111 TWELVE OAKS CENTER DR",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055202",
            "telephone_number": "952-993-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15111 TWELVE OAKS CENTER DR",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055202",
            "telephone_number": "952-993-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "717 Delaware St SE",
            "address_2": "1932K (Campus Delivery Code), Suite 353",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554142959",
            "country_code": "US",
            "telephone_number": "612-626-2953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIGNOR",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "67050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BECKER",
            "middle_name": "RENEE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lexi J Sibert, BCBA
• Emma K Siefker
• Judy D Siems, PHD LADC
• Alicia Sifuentes
• Manju Sigdel-Regmi, NP-C
• Emily Claire Sikkink
• Angelina Silvas, FNP
• Duncan Simmons, MD
• Margaret Suzanne Simmons, NP
• Simply Connect

• Pediatrics Physician in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.