JESSICA L HODSON (NPI# 1942438270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942438270 |
| Entity Type | Individual |
| Full Name | JESSICA L HODSON |
| Credential | DO |
| Practice Address |
16830 198th Ave Nw Centracare Clinic Big Lake Big Lake MN 55309-4860 |
| Mailing Address |
16830 198th Avenue Nw Po Box 539 Centracare Clinic Big Lake Big Lake MN 55309-4860 |
| Practice Telephone | 7632637300 |
| Practice Fax Number | 7632637334 |
| Mailing Telephone | 7632637300 |
| Mailing Fax Number | 7632637334 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2015-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 54811 | MN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 156397 | NC | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205369634 | Jessica Priscilla Makanani Hodson | Social Worker | 3627 Kilauea Ave, Honolulu, HI 96816-2317 | 2017-04-03 |
| Street Address |
16830 198TH AVE NW CENTRACARE CLINIC BIG LAKE |
| City | BIG LAKE |
| State | MN |
| Zip Code | 55309-4860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801873674 | Glenn W Weidenbacher | Pediatrics | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2005-12-22 |
| 1003226416 | Sarah E Johnson | Dietitian, Registered | 16830 198th Ave Nw, Centracare Clinic - Big Lake, Big Lake, MN 55309-4860 | 2014-05-07 |
| 1043479876 | Nabeel Bishara Ailabouni | Family Medicine | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2008-06-06 |
| 1013104348 | Centracare Clinic | Durable Medical Equipment & Medical Supplies | 16830 198th Ave Nw, Centracare Clinic - Big Lake, Big Lake, MN 55309-4860 | 2007-10-01 |
| 1720118912 | Luke A. Herdina | Physician Assistant | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2007-03-06 |
| 1801845391 | St. Cloud Hospital | Clinic/Center | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2006-05-10 |
| 1417924994 | Lola B Sutherland | Family Medicine | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356986475 | Barbro E Strom Langley | Technician | 16901 River View Cir, Big Lake, MN 55309 | 2019-11-13 |
| 1629589544 | Pdg, Pa | Clinic/Center | 16991 198th Ave Nw, Big Lake, MN 55309 | 2017-10-18 |
| 1669821765 | Laura Ann Dill | Dentist | 290 Eagle Lake Rd N, Big Lake, MN 55309 | 2016-06-09 |
| 1295008068 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 171 Henry Road, Big Lake, MN 55309 | 2012-02-09 |
| 1013280882 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 177 Henry Road, Big Lake, MN 55309 | 2012-02-09 |
| 1760704712 | Mary Ellen Venzke | Adult Companion | 19729 183rd Avenue, Big Lake, MN 55309 | 2010-02-18 |
| 1174700611 | Country Services Inc | Case Management | 641 Park Ave E, Big Lake, MN 55309 | 2008-01-28 |
| 1942481593 | Monticello Dental Group | Dentist | 20460 Co. Rd.11 Nw, Big Lake, MN 55309 | 2007-11-23 |
| 1336367242 | Family Prospective Resources, Inc | Marriage & Family Therapist | 35 Lake St So, Big Lake, MN 55309 | 2007-04-23 |
| 1598983470 | Jennifer Ann Lawrence | Marriage & Family Therapist | 35 Lake Street South #200, Big Lake, MN 55309 | 2007-04-23 |
| Find all providers in zip 55309 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811954332 | Joseph E Sudolcan | Family Medicine | 800 N Main Ave Ste 3, Big Lake, TX 76932-3900 | 2006-04-27 |
| 1043479876 | Nabeel Bishara Ailabouni | Family Medicine | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2008-06-06 |
| 1417924994 | Lola B Sutherland | Family Medicine | 16830 198th Ave Nw, Big Lake Clinic, Big Lake, MN 55309 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349280 | Anna Dalrymple | Family Medicine | 3832 Mcknight Rd N, White Bear Lake, MN 55110-4874 | 2020-09-07 |
| 1760005771 | Revive Pain Centers Pa | Family Medicine | 14525 Highway 7 Ste 375, Minnetonka, MN 55345-3741 | 2020-05-26 |
| 1245862697 | North Iowa Mercy Clinics | Family Medicine | 2440 Bridge Ave, Albert Lea, MN 56007-2005 | 2020-02-04 |
| 1477196715 | The Doctors Medical Clinic, P.a. | Family Medicine | 1504 Whitebear Ave, St Paul, MN 55106 | 2019-10-18 |
| 1699336511 | Ruth Archibald | Family Medicine | 6962 Cottonwood Ct Nw, Rochester, MN 55901-8835 | 2019-06-21 |
| 1295399251 | Roberta Lynn Kopel | Family Medicine | 1605 W Lincoln Ave, Olivia, MN 56277-1260 | 2019-04-25 |
| 1558834390 | Donna Mae Mullenix | Family Medicine | 2849 Cty Rd 103, Barnum, MN 55707 | 2019-01-04 |
| 1083189203 | Altru Health System | Family Medicine | 23076 347th Street Se, Erskine, MN 56535-9466 | 2018-10-04 |
| 1477039204 | Dollar Clinic Pllc | Family Medicine | 1002 1st Ave N, Moorhead, MN 56560-2003 | 2018-07-16 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.