Jenna Elizabeth Erickson, CNM. IBCLC

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

542 Issued in MN

Practice address

425 241St St
Balaton, MN 56115-1107

Phone

(507) 430-0636

NPI assigned

Dec 23, 2019

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

• Jenna Elizabeth Hansen Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

CCM HealthGroup PAC ID 4284539453, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerickson739471@direct.centracare.com

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.

• CCM Health

  • Critical Access Hospital
  • Montevideo, MN
  • NPI 1720086028

  MN

  Medicare reassignment Care Compare group NPD
• Southwest Minnesota Lactation and Beyond, LLC

  • Lactation Consultant (Non-RN)
  • Marshall, MN
  • NPI 1184417222

  Lactation Consultant

  NPD Authorized official
• CCM Health

  • Rural Health Clinic/Center
  • Milan, MN
  • NPI 1457132466
  NPD
• CCM Health

  • Rural Health Clinic/Center
  • Montevideo, MN
  • NPI 1407636475
  NPD (past)
• CCM Health

  • Rural Health Clinic/Center
  • Marshall, MN
  • NPI 1487436655
  NPD (past)

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1982243903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 241ST ST",
            "city": "BALATON",
            "state": "MN",
            "postal_code": "561151107",
            "telephone_number": "507-430-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 241ST ST",
            "city": "BALATON",
            "state": "MN",
            "postal_code": "561151107",
            "telephone_number": "507-430-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JENNA",
        "middle_name": "ELIZABETH",
        "credential": "CNM. IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MN",
            "license": "R-193011-1",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "HANSEN",
            "middle_name": "ELIZABETH",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Balaton Dental Clinic,Inc
• Balaton Public School
• Richard Wallace Brown, DDS
• City of Balaton
• Kathryn Determan, DDS
• Lsi Services, LLC
• Amy Perlenfein

• All providers in Balaton, MN
• Advanced Practice Midwife in Minnesota

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