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MS. KAYLEN MCNAMARA JAMES JACKSON R.D., L.D., C.D.E.
NPI 1225334709
Dietitian, Registered in Shakopee, MN

Active since February 01, 2011
1415 SAINT FRANCIS AVE, SHAKOPEE, MN 55379(952) 993-3742 Get Directions Write a Review

NPPES record last updated: June 27, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ms. Kaylen Mcnamara James Jackson R.d., L.d., C.d.e. NPPES

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

MS. KAYLEN MCNAMARA JAMES JACKSON R.D., L.D., C.D.E. (NPI 1225334709) is an individual dietitian, registered in Shakopee, Minnesota, licensed in Minnesota (01021614) and active in the NPI registry since February 2011.

NPPES Registry Identity

NPI1225334709
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMS. KAYLEN MCNAMARA JAMES JACKSONCredential: R.D., L.D., C.D.E.
Location Address1415 SAINT FRANCIS AVEShakopee, MN 55379-3374
Mailing Address8170 33rd Avenue South, Mail Stop 21110qMinneapolis, MN 55440 · (952) 883-6212
Phone(952) 993-3742
Sole ProprietorNo
Enumeration DateFebruary 1, 2011
Last NPPES UpdateJune 27, 2016
✔ NPI 1225334709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in MN · 01021614
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
1415 SAINT FRANCIS AVE, Shakopee, MN 55379
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Other Names 1

Former Name (1)Kaylen Mcnamara James R.d., L.d.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kaylen Mcnamara James Jackson R.d., L.d., C.d.e. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

Park Nicollet Methodist Hospital
14 mi
General Acute Care Hospital
3900 PARK NICOLLET BLVD
St Louis Park, MN 55416
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: Park Nicollet Clinic
  • 2,527 clinicians in this Medicare group
NPI 1194113217 (952) 993-1953

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

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.

KRISTIN A WITTE D.O.
Family Medicine
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Scott County (952) 993-7750
ANN M. O'DONNELL M.D.
Obstetrics & Gynecology
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Scott County (952) 993-7750
MARK WESTHOLDER
Family Medicine
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Scott County (952) 993-7800
DR. TREVOR L BUSCH MD
Family Medicine
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Scott County (952) 993-7750
CRYSTAL J KNUTSON M.D.
Pediatrics
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Scott County (952) 993-7750
LISA KROHN PHARMD
Pharmacist
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Scott County (952) 993-4342
SUSAN TORKELSON
Obstetrics & Gynecology
1415 SAINT FRANCIS AVE, SUITE 200
SHAKOPEE, MN 55379
Scott County (952) 993-7750
JENNIFER E GRUNDHOFER PA-C
Physician Assistant
1415 SAINT FRANCIS AVE
SHAKOPEE, MN 55379
Scott County (952) 993-7750

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 Kaylen Jackson's NPI number?

The NPI number for Kaylen Jackson is 1225334709. It was assigned to this individual provider in the NPPES registry on February 1, 2011. The provider is also known as Kaylen Mcnamara James R.D., L.D..

Where is Kaylen Jackson located?

Kaylen Jackson practices at 1415 Saint Francis Ave, Shakopee, MN 55379. The listed phone number is (952) 993-3742.

What is Kaylen Jackson's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Kaylen Jackson enrolled in Medicare?

Yes. Kaylen Jackson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kaylen Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaylen Jackson reassigns Medicare benefits to Park Nicollet Methodist Hospital (St Louis Park, 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 Kaylen Jackson'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 Kaylen Jackson was last updated on June 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.