Jennifer Vickers, RN, DNP, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

876 Issued in MN

Practice address

19685 Pilot Knob Rd Ste 100
Farmington, MN 55024-7238

Phone

(651) 602-7500

Fax

(651) 602-7580

NPI assigned

Aug 27, 2014

Last updated

Jan 19, 2022By 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

Other names 1

• Jennifer Phillips 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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Side Community Health Services, Inc.Group PAC ID 2062306434, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jvickers733240@direct.ochin.org

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.

• West Side Community Health Services, Inc.

  dba McDonough Homes Clinic

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1821149964
  Medicare reassignment Care Compare group NPD
• West Side Community Health Services, Inc.

  dba MINNESOTA COMMUNITY CARE MBC - St. Paul

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1043187289
  NPD
• West Side Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1982346409
  NPD

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1982004941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19685 PILOT KNOB RD STE 100",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550247238",
            "telephone_number": "651-602-7500",
            "fax_number": "651-602-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19685 PILOT KNOB RD STE 100",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550247238",
            "telephone_number": "651-602-7500",
            "fax_number": "651-602-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "JENNIFER",
        "credential": "RN, DNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "178729-6",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PHILLIPS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiptop Care LLC
• Tiptop Interpreters LLC
• Jessica A Tri, DDS
• David E Truax, D.C.
• Lori L Utech, M.D.
• Kimberly A Wakefield
• Claudia Lorena Waples
• West Side Community Health Services Inc
• West Side Community Health Services, Inc
• Lori Ann Wiedner, LPCC

• Nurse Practitioner in Farmington, MN
• Providers in Farmington, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.