DR. JODI RAE BOERGER WILDER LP
NPI 1699744227
Psychologist in Detroit Lakes, MN

Active since March 16, 2006PECOS Enrolled
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501(218) 846-2000(218) 846-2114 Get Directions Write a Review

NPPES record last updated: March 8, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 8, 2023, Dec 23, 2015 (2 updates tracked since 2015).

About Dr. Jodi Rae Boerger Wilder Lp NPPES

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

DR. JODI RAE BOERGER WILDER LP (NPI 1699744227) is an individual psychologist in Detroit Lakes, Minnesota, licensed in Minnesota (LP4398) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fosston.

NPPES Registry Identity

NPI1699744227
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. JODI RAE BOERGER WILDERCredential: LP
Location Address1245 WASHINGTON AVEDetroit Lakes, MN 56501-3905
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074
Fax(218) 846-2114
Sole ProprietorNo
Enumeration DateMarch 16, 2006
Last NPPES UpdateMarch 8, 20232 updates tracked since enumeration
NPPES CertifiedMarch 8, 2023
NPI 1699744227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP4398
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License LP4398 (MN)
1245 WASHINGTON AVE, Detroit Lakes, MN 56501

Secondary Practice Location 1

Location 1900 Hilligoss Blvd SEFosston, MN 56542-1542 · Phone (218) 435-1133 · Fax (218) 435-1134

Other Identifiers 8

OtherHP37004Health Partners
Medicaid629899100MN
Medicaid1699744227MN
Other22522ND · Bcbs Of Nd
Other1032397Preferred One
Other310T1B0MN · Bcbs Bhst
Other171126MN · Ucare Altru
Other6159749MN · Ubh Medica

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jodi Rae Boerger Wilder Lp 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.

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.

Physical Therapist
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501
Nurse Practitioner
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501
Nurse Practitioner
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501
Psychologist
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501
Dietitian, Registered
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501
Dermatology
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501
Social Worker (Clinical)
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501
Obstetrics & Gynecology
1245 WASHINGTON AVE
DETROIT LAKES, MN 56501

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 Jodi Boerger Wilder's NPI number?

The NPI number for Jodi Boerger Wilder is 1699744227. It was assigned to this individual provider in the NPPES registry on March 16, 2006.

Where is Jodi Boerger Wilder located?

Jodi Boerger Wilder practices at 1245 Washington Ave, Detroit Lakes, MN 56501. The listed phone number is (218) 846-2000.

What is Jodi Boerger Wilder's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jodi Boerger Wilder enrolled in Medicare?

Yes. Jodi Boerger Wilder is registered in the Medicare PECOS enrollment system.

What insurance does Jodi Boerger Wilder accept?

Health plans from Blue Cross Blue Shield of North Dakota, HealthPartners, Sanford Health Plan and Security Health Plan list Jodi Boerger Wilder as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jodi Boerger Wilder was last updated on March 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.