Active NPI
Jill T Stang, ANP
- Adult Health Nurse Practitioner
- St Cloud, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- R1237351
- Practice address
- 1520 Northway Court
Centracare Clinic Heartland
St Cloud, MN 56303 - Phone
- (320) 251-1775
- Fax
- (320) 240-3131
- NPI assigned
- Oct 31, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | R1237351 | MN | Primary |
Addresses
Primary practice location
1520 Northway Court
Centracare Clinic Heartland
St Cloud, MN 56303
Mailing address
1520 Northway Court
Centracare Clinic Heartland
St Cloud, MN 56303
Phone (320) 251-1775
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002219500 | Other | MEDICAL ASSISTANCE | |
| 1014181 | Other | PREFERRED ONE | |
| 86D79ST | Other | BLUE CROSS BLUE SHIELD | |
| HP23116 | Other | HEALTH PARTNERS | |
| R1237351 | Other | MN LICENSE NUMBER | |
| 0110555 | Other | MEDICA HEALTH PLANS | |
| 122925 | Other | U CARE |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1200 6TH Ave N
Saint Cloud, MN 56303-2735
1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131
12800 Rolling Ridge Rd
Becker, MN 55308-8838
Phone (763) 261-7000
1555 Northway Dr
100 Centra Care Clinic Northway Family
St Cloud, MN 56303-1258
Phone (320) 251-1775
PO Box
Chicago, IL 60673
Hospital & facility affiliations
- Centracare - St. Cloud Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1237351 | MN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Clinic | Current | Accepting new patients | |
| Centracare Clinic | Current | Accepting new patients | |
| Centracare Clinic | Current | Accepting new patients | |
| Centracare Clinic | Past | Accepting new patients | |
| Centracare Clinic | Past | Accepting new patients |
Locations
12800 Rolling Ridge Rd
Becker, MN 55308
Phone (763) 261-7000
715 1st St N
Cold Spring, MN 56320
Phone (320) 685-3693
1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422
1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342
1555 Northway Dr
Ste 100
Saint Cloud, MN 56303
Phone (320) 240-3114
Interoperability endpoints
- jstang846@direct.centracare.com
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- St Cloud, MN
- NPI 1043212665
-
- Occupational Medicine Clinic/Center
- Saint Cloud, MN
- NPI 1366192759
-
- Multi-Specialty Clinic/Center
- Saint Cloud, MN
- NPI 1881696490
-
- Multi-Specialty Clinic/Center
- St Joseph, MN
- NPI 1134121759
-
- Multi-Specialty Clinic/Center
- Saint Cloud, MN
- NPI 1225030844
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Saint Cloud, MN
- NPI 1811150618
-
- General Acute Care Hospital
- Saint Cloud, MN
- NPI 1043269798
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Saint Cloud, MN
- NPI 1467615294
-
- General Acute Care Hospital
- Saint Cloud, MN
- NPI 1841502929
-
- Psychiatric Hospital Unit
- Saint Cloud, MN
- NPI 1932419058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1992796841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1520 NORTHWAY COURT",
"address_2": "CENTRACARE CLINIC HEARTLAND",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "56303",
"telephone_number": "320-251-1775",
"fax_number": "320-240-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 NORTHWAY COURT",
"address_2": "CENTRACARE CLINIC HEARTLAND",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "56303",
"telephone_number": "320-251-1775",
"fax_number": "320-240-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANG",
"first_name": "JILL",
"middle_name": "T",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-31",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MN",
"license": "R1237351",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE",
"identifier": "002219500",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1014181",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "86D79ST",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP23116",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MN LICENSE NUMBER",
"identifier": "R1237351",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA HEALTH PLANS",
"identifier": "0110555",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U CARE",
"identifier": "122925",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.