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JEANNIE ELIZABETH CLARK CNP
NPI 1013724103
Nurse Practitioner in Rochester, MN

Active since December 12, 2024PECOS Enrolled
200 FIRST STREET SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: February 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 13, 2025, Dec 12, 2024 (2 updates tracked since 2024).

About Jeannie Elizabeth Clark Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEANNIE ELIZABETH CLARK CNP (NPI 1013724103) is an individual nurse practitioner in Rochester, Minnesota, licensed in Minnesota (12148) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013724103
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameJEANNIE ELIZABETH CLARKCredential: CNP
Location Address200 FIRST STREET SWRochester, MN 55905-0001
Mailing AddressPo Box 860912Minneapolis, MN 55486-0912 · (507) 284-2511
Phone(507) 284-2511
Sole ProprietorNo
Enumeration DateDecember 12, 2024
Last NPPES UpdateFebruary 13, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2025
✔ NPI 1013724103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MN · 12148
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
200 FIRST STREET SW, Rochester, MN 55905
Open in Google Maps ↗

Other Names 1

Former Name (1)Jeannie Elizabeth Dybdal Aprn, Cnp

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeannie Elizabeth Clark Cnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jeannie Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mayo Clinic
Same address
Infectious Disease
200 1ST ST SW
Rochester, MN 55905
  • Reassigned Medicare billing, Minnesota enrollment
  • 6,534 clinicians in this Medicare group
NPI 1114343860 (507) 284-2511

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TANNER AUSTON MELTON PHARMD
Pharmacist
200 FIRST STREET SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
JAMES WILLIAMS ATC/ATR, CSCS
Specialist/Technologist (Athletic Trainer)
200 FIRST STREET SW
ROCHESTER, MN 55905
Olmsted County (507) 266-7800
MAYO CLINIC
Hospice Care, Community Based
200 FIRST STREET SW
ROCHESTER, MN 55905
Olmsted County (507) 284-4002
LAUREN ELYSE PENZ MD
Physical Medicine & Rehabilitation
200 FIRST STREET SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
BRITTANY ANN FRIAR
Nurse Practitioner
200 FIRST STREET SW
ROCHESTER, MN 55905
Olmsted County (608) 485-2705
ALISON SEEMANN PA-C
Physician Assistant
200 FIRST STREET SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511
DR. BRENDAN PUTKO MD
Psychiatry & Neurology (Neurology)
200 FIRST STREET SW
ROCHESTER, MN 55905
Olmsted County (507) 284-8305
COURTNEY SWENSON
Nurse Practitioner
200 FIRST STREET SW
ROCHESTER, MN 55905
Olmsted County (507) 284-2511

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeannie Clark's NPI number?

The NPI number for Jeannie Clark is 1013724103. It was assigned to this individual provider in the NPPES registry on December 12, 2024. The provider is also known as Jeannie Elizabeth Dybdal Aprn, Cnp.

Where is Jeannie Clark located?

Jeannie Clark practices at 200 First Street SW, Rochester, MN 55905. The listed phone number is (507) 284-2511.

What is Jeannie Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jeannie Clark enrolled in Medicare?

Yes. Jeannie Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jeannie Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeannie Clark reassigns Medicare benefits to Mayo Clinic (Rochester, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeannie Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeannie Clark was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.