AVERA TYLER (NPI# 1063949089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063949089 |
Entity Type | Organization |
Organization Name | AVERA TYLER |
Other Organization Name | AVERA MEDICAL GROUP IVANHOE |
Practice Address |
312 E George St Ivanhoe MN 56142-9707 |
Mailing Address |
300 S Bruce St Marshall MN 56258-1934 |
Practice Telephone | 5076941414 |
Enumeration Date | 2017-05-22 |
Last Update Date | 2020-09-10 |
Authorized Official Name | MARY MAERTENS (PRESIDENT/CEO) |
Authorized Official Telephone | 5075379160 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Avera Medical Group Ivanhoe | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003869892 | Avera Tyler | Clinic/Center | 109 E Benton St, Lake Benton, MN 56149-1309 | 2006-05-19 |
1326102237 | Avera Tyler | Medicare Defined Swing Bed Unit | 240 Willow Street, Tyler, MN 56178 | 2006-12-22 |
1821042920 | Avera Tyler | Skilled Nursing Facility | 240 Willow St, Tyler, MN 56178-1166 | 2006-05-22 |
1649223439 | Avera Tyler | Clinic/Center | 240 Willow St, Tyler, MN 56178-0240 | 2006-05-19 |
1992759674 | Avera Tyler | Home Health | 240 Willow St, Tyler, MN 56178-1166 | 2006-05-19 |
1871546606 | Avera Tyler | Hospice Care, Community Based | 240 Willow St., Tyler, MN 56178-0240 | 2006-05-19 |
1801840517 | Avera Tyler | General Acute Care Hospital | 240 Willow St., Tyler, MN 56178-0240 | 2006-05-19 |
Street Address |
312 E GEORGE ST |
City | IVANHOE |
State | MN |
Zip Code | 56142-9707 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629014733 | Divine Providence Heatlh Center | General Acute Care Hospital | 312 E George St, Ivanhoe, MN 56142-9707 | 2006-06-20 |
1902246168 | Avera Marshall | Nurse Practitioner | 312 E George St, Ivanhoe, MN 56142-9707 | 2013-07-02 |
1972660488 | Divine Providence Medical Clinic | Clinic/Center | 312 E George St, Ivanhoe, MN 56142-9707 | 2007-01-03 |
1265467526 | Divine Providence Health Center | Medicare Defined Swing Bed Unit | 312 E George St, Ivanhoe, MN 56142-9707 | 2006-07-12 |
1730113234 | Divine Providence Heatlh Center Inc. | Home Health | 312 E George St, Ivanhoe, MN 56142-9707 | 2006-07-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992713739 | Dawn R Bucher | Nurse Practitioner | 121 Saxon Ave West, Ivanhoe, MN 56142 | 2006-08-04 |
1861537482 | City of Ivanhoe | Ambulance | 401 North Harold Street, Ivanhoe, MN 56142-0054 | 2007-02-21 |
1780752915 | Richard Dean Mulder | Family Medicine | 121 Saxon Ave W, Ivanhoe, MN 56142-0076 | 2006-12-04 |
1215005442 | Timothy E Nealy | Family Medicine | 121 W Saxon Ave, Ivanhoe, MN 56142-0076 | 2006-12-04 |
1326072406 | Divine Providence Health Center Inc | Skilled Nursing Facility | 312 East George Street, Ivanhoe, MN 56142-0136 | 2006-07-11 |
1316162308 | Ivanhoe Clinic | Clinic/Center | 121 W Saxon St, Ivanhoe, MN 56142-9504 | 2007-04-16 |
1932345436 | Ashley Darlene Conner | Respite Care | 321 W Saxon St, Ivanhoe, MN 56142-9555 | 2009-01-05 |
1548644214 | Andrea Hofmeyer-lustfield | Counselor | 321 W Saxon St, Ivanhoe, MN 56142-9555 | 2015-07-13 |
1265664130 | Lincoln County Heartland Express | Bus | 319 N Rebecca St # 29, Ivanhoe, MN 56142-9572 | 2009-08-11 |
1952690034 | Hendricks Community Hospital Assn & Retirement Home | Clinic/Center | 315 N Norman St, Ivanhoe, MN 56142-9580 | 2011-03-29 |
Find all providers in zip 56142 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952690034 | Hendricks Community Hospital Assn & Retirement Home | Clinic/Center | 315 N Norman St, Ivanhoe, MN 56142-9580 | 2011-03-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902364482 | St Mary's Regional Health Center | Clinic/Center | 300 E Main Ave, Frazee, MN 56544-4504 | 2019-03-04 |
1508378324 | International Falls Memorial Hospital Association | Clinic/Center | 912 Main St Unit C, Littlefork, MN 56653-9379 | 2017-11-02 |
1407262405 | Tri-county Hospital, Inc. | Clinic/Center | 102 Farwell St S, Verndale, MN 56481 | 2014-07-10 |
1457624272 | Sanford Health of Northern Minnesota | Clinic/Center | 22 Elm St Nw, Clearbrook, MN 56634 | 2012-02-10 |
1750671186 | Riverview Healthcare Association | Clinic/Center | 306 N Mill St, Fertile, MN 56540-4330 | 2011-04-19 |
1992012207 | County of Kanabec | Clinic/Center | 1425 Main Street North, Pine City, MN 55063-1530 | 2010-09-08 |
1578736492 | Healthpartners Rc | Clinic/Center | 131 Birch Avenue, Hector, MN 55342-0117 | 2008-04-11 |
1730352675 | Healthpartners Rc | Clinic/Center | 420 Main Street North, Renville, MN 56284-0606 | 2008-04-11 |
1578735833 | County of Murray | Clinic/Center | 119 N St Paul Ave, Fulda, MN 56131-1156 | 2008-03-27 |
1659568020 | Centracare Health System-long Prairie | Clinic/Center | 815 Highway 71 South, Eagle Valley Clinic, Eagle Bend, MN 56446-0298 | 2007-10-01 |
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.