JONATHAN PHILIP BEARDSLEY (NP) – Family Nurse Practitioner, NPI 1114637956

JONATHAN PHILIP BEARDSLEY (NP) is a healthcare provider. based in Faribault, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 9772 (MN). The NPI Number for JONATHAN PHILIP BEARDSLEY (NP) is 1114637956

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN PHILIP BEARDSLEY (NP)
NPI
1114637956
Phone
(507) 330-1158
Address
100 State Ave
Enumeration Date
2 December 2022
Last Update Date
10 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6128634000
Graduation Year
2022 (4 years ago)
PAC ID
1052781812
Group Practice PAC ID
4587573613
Professional Enrollment ID
I20230112001328
Address ID
MN554071321MI2925XAVEX300

Contacts

Secure Messaging
jbeardsley104876@excellian.direct.allina.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:3State licenses:1Other namesUpdated within 12 months

5,720 NURSE PRACTITIONER in MN

Provider Addresses for JONATHAN PHILIP BEARDSLEY (NP)

  • 100 State Ave

    Faribault, MN 550216337

    Phone: (507) 330-1158

    Type: Location

  • 2925 CHICAGO AVE

    MINNEAPOLIS, MN 554071321

    Phone: (612) 262-9000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230112001328INurse PractitionerMNTBD
I20250529000962INurse PractitionerWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55021)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587573613View full group profile

Reviews

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Frequently asked questions

What identifier follows JONATHAN PHILIP BEARDSLEY (NP) across health systems?
The NPI 1114637956 uniquely identifies JONATHAN PHILIP BEARDSLEY (NP) in U.S. healthcare data.
Should I treat JONATHAN PHILIP BEARDSLEY (NP) as an active provider?
Patients and plans typically see JONATHAN PHILIP BEARDSLEY (NP) as active in the national extract.
How should patients interpret JONATHAN PHILIP BEARDSLEY (NP)'s specialty?
The extract shows Family Nurse Practitioner for JONATHAN PHILIP BEARDSLEY (NP). Clinical services aligned with this taxonomy classification.
Can patients visit JONATHAN PHILIP BEARDSLEY (NP) in Faribault, Minnesota?
For routing, start with Faribault, Minnesota for JONATHAN PHILIP BEARDSLEY (NP), then verify phone and hours locally.
Who maintains JONATHAN PHILIP BEARDSLEY (NP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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