JACQUELYN JOSIE ANDERSON DO
NPI 1174379754
Student in an Organized Health Care Education/Training Program in Saint Cloud, MN
NPI Status: Active since April 25, 2024
Contact Information
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 240-3157
- Individual
- Female
- Student in an Organized Health Care Educ...
- PECOS Enrolled
About JACQUELYN ANDERSON
This page provides the complete NPI Profile along with additional information for Jacquelyn Anderson, a primary care provider established in Saint Cloud, Minnesota with a medical specialization in Student In An Organized Health Care Education/training Program. The healthcare provider is registered in the NPI registry with number 1174379754 assigned on April 2024. The practitioner's primary taxonomy code is 390200000X. The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1174379754
- Provider Name
- JACQUELYN JOSIE ANDERSON DO
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303
- Location Phone
- (320) 240-3157
- Mailing Address
- 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303
- Mailing Phone
- (320) 240-3157
- Mailing Fax
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-25-2024
- Last Update Date
- 04-25-2024
- Code Navigator
A primary care provider (PCP) like Jacquelyn Anderson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Student in an Organized Health Care Education/Training Program
- Taxonomy Code
- 390200000X
- Type
- Student, Health Care
- Taxonomy Description
- An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Medicare Participation & PECOS Enrollment Status
Jacquelyn Anderson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 3 | 7 | 9 | 7 | 5 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 6 | 7 | 18 | 7 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 6 + 7 + 1 + 8 + 7 + 1 + 0 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1174379754 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1851942007 | ELIZABETH LOUISE FIEDLER Individual | Nurse Practitioner (Family) | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1659869766 | DR. ERIC DAVID CHRISTENSEN MD Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3112 |
| 1710559406 | HAILEY HAUGEN PHARMD Individual | Pharmacist (Ambulatory Care) | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1407290604 | FRANCES TEPOLT MD Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1447813431 | OLUWATOBI OLUSHOGA FALADE MBBS Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3112 |
| 1275267270 | KWON PARK PHARMD Individual | Pharmacist | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3102 |
| 1679193957 | SETH NELSON Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3112 |
| 1437106986 | CLARICE HANKS KONSHOK MD Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1912460734 | GAMALIEL JESSE FERRER MD Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1205523644 | RICHARD DUNNING DO Individual | Student in an Organized Health Care Education/Training Program | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1821726639 | RACHEL DEE WOEHLER CNP Individual | Nurse Practitioner (Family) | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1841802436 | LAUREN MARTENS SCHLUENZ PHARMD Individual | Pharmacist | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 251-2700 |
| 1023709094 | SARA TAROKH MD Individual | Student in an Organized Health Care Education/Training Program | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3112 |
| 1245929843 | DR. JOEL ADAM MADSON MD Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1093336299 | JENNIFER ANN TARPENNING MD Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1831770288 | MEGAN KROTZER Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3112 |
| 1043832132 | SADIO AHMED MOHAMED MD Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1679216865 | LUKE MCFARLAND DO Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1518602820 | KRISTINA TESTER-KLASHNYA CHIEN MD, JD Individual | Family Medicine | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
| 1265278006 | CARA BETH HELGESON PHARMD Individual | Pharmacist (Ambulatory Care) | 1555 NORTHWAY DR STE 200 SAINT CLOUD, MN 56303 (320) 240-3157 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174379754, enumerated in the NPI registry as an "individual" on April 25, 2024
The provider is located at 1555 Northway Dr Ste 200 Saint Cloud, Mn 56303 and the phone number is (320) 240-3157
The provider's speciality is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on April 25, 2024. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.