AVERA MARSHALL (NPI# 1568401016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568401016 |
| Entity Type | Organization |
| Organization Name | AVERA MARSHALL |
| Other Organization Name | AVERA MARSHALL REGIONAL MEDICAL CENTER |
| Practice Address |
300 S Bruce St Marshall MN 56258-1934 |
| Practice Telephone | 5075329661 |
| Mailing Telephone | 5075329661 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2010-01-13 |
| Authorized Official Name | SHARON WILLIAMS (CFO) |
| Authorized Official Telephone | 5075379150 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
331067 | MN | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 019545600 | 05 |
| Other Name | Type Code |
|---|---|
| Avera Marshall Regional Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396229746 | Avera Marshall | Clinic/Center | 1521 Carlson St Ste 200, Marshall, MN 56258-2626 | 2018-09-21 |
| 1154856839 | Avera Marshall | Clinic/Center | 300 S Bruce St Ste D, Marshall, MN 56258-1934 | 2017-05-01 |
| 1962859058 | Avera Marshall | Dentist | 197 N Tyler St, Tyler, MN 56178-1160 | 2016-05-18 |
| 1508177890 | Avera Marshall | Ophthalmology | 1040 3rd Ave, Mountain Lake, MN 56159-1587 | 2010-07-01 |
| 1346297041 | Avera Marshall | Home Health | 1104 E College Dr, Marshall, MN 56258-4270 | 2006-05-28 |
| 1659838290 | Avera Marshall | Occupational Therapist | 1420 E College Dr Ste 704, Marshall, MN 56258-2065 | 2019-03-01 |
| 1407330301 | Avera Marshall | Clinic/Center | 1521 Carlson St, Marshall, MN 56258-2626 | 2018-09-18 |
| 1437551785 | Avera Marshall | Clinic/Center | 300 S Bruce St, Marshall, MN 56258-1934 | 2014-09-18 |
| 1649688623 | Avera Marshall | Clinic/Center | 300 S Bruce St, Marshall, MN 56258-1934 | 2014-07-23 |
| 1710303227 | Avera Marshall | Clinic/Center | 300 S Bruce St, Marshall, MN 56258-1934 | 2014-03-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AVERA MARSHALL REGIONAL MEDICAL CENTER | 300 S Bruce St, Marshall, MN 56258-1934 |
| Street Address |
300 S BRUCE ST |
| City | MARSHALL |
| State | MN |
| Zip Code | 56258-1934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922003409 | Alain Desy | Orthopaedic Surgery | 300 S Bruce St, Marshall, MN 56258-1934 | 2005-06-20 |
| 1336750702 | Neil Thomas Eichten | Speech-Language Pathologist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-08-11 |
| 1427669894 | Victoria Ann Botten | Speech-Language Pathologist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-08-11 |
| 1811506694 | Kendall Drew Hines | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-07-28 |
| 1053934877 | Karen Marie Kersting | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-05-27 |
| 1306474747 | Ramy Vandendriessche | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-03-31 |
| 1114576535 | Analisa Kay Buysse | Pharmacist | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-09-09 |
| 1346894748 | Jacob Bottelberghe | Physician Assistant | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-07-25 |
| 1598224321 | Hannah Sue Reski | Physician Assistant | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-03-19 |
| 1245709443 | Amy Marie Meyeraan-rowe | Nurse Practitioner | 300 S Bruce St, Marshall, MN 56258-1934 | 2018-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285140012 | Action Manufacturing Inc | Durable Medical Equipment & Medical Supplies | 1105 Lake Road, Marshall, MN 56258 | 2017-12-15 |
| 1124579123 | Themarshrx | Durable Medical Equipment & Medical Supplies | 600 Sherman Ave, Marshall, MN 56258 | 2016-10-14 |
| 1780020370 | Heritage Pointe Senio | Assisted Living Facility | 207 N 4th Street, Marshall, MI 56258 | 2013-05-22 |
| 1528351178 | Lori Anne Lynner | Family Medicine | 3160 Us Hwy 59, Marshall, MN 56258 | 2011-05-16 |
| 1912148545 | Tami J Behnke | Counselor | 1418 State Street, Campus Religious Center, Marshall, MN 56258 | 2009-03-11 |
| 1073768396 | Sharyce Marie Audiology Inc | Audiologist | 1424 East College Drive, Suite 200, Marshall, MN 56258 | 2008-12-01 |
| 1497976625 | Erica Anne Jost | Specialist/Technologist | 1501 State Street, Marshall, MN 56258 | 2007-05-02 |
| 1265597470 | Nancy Louise Hemmingson | Optometrist | 300 S Bruce Street, Avera Marshall Southwest Ophthalmology, Marshall, MN 56258 | 2006-12-27 |
| 1407928187 | Midwest Vision Centers Inc | Technician/Technologist | 1113 E College Drive, Marshall, MN 56258 | 2006-11-15 |
| 1306918354 | Paul Joseph Puetz | Chiropractor | 111 Jewett St, Marshall, MN 56258 | 2006-11-14 |
| Find all providers in zip 56258 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730565185 | Eric Ray Watt | General Acute Care Hospital | 7309 E Franklin Cir, Eden Prairie, MN 55346-3818 | 2015-08-08 |
| 1659618742 | Madelia Com Hospital Inc. | General Acute Care Hospital | 621 W Nathan St, Lake Crystal, MN 56055-2116 | 2013-01-09 |
| 1932468683 | Lakewood Health System | General Acute Care Hospital | 401 Prairie Ave. N., 49725 Co. Hwy 83, Staples, MN 56479 | 2012-05-15 |
| 1912121484 | Ely Bloomenson Community Hospital & Nursing Home | General Acute Care Hospital | 328 W Conan Street, Ely, MN 55731-1198 | 2007-04-13 |
| 1295859411 | Clearwater County Memorial Hospital | General Acute Care Hospital | 203 4th St. N.w., Bagley, MN 56621 | 2007-03-16 |
| 1174668081 | Timoth Y John Peterson | General Acute Care Hospital | St. Francis Healthcare Campus, 2400 St. Francis Drive, Breckenridge, MN 56520 | 2007-02-20 |
| 1487712493 | Cook County Hospital District | General Acute Care Hospital | 515 5th Ave W, Grand Marais, MN 55604-3017 | 2006-12-04 |
| 1316014202 | St Josephs Community Dental Clinic | General Acute Care Hospital | 205 Pleasant Ave S, Park Rapids, MN 56470-1434 | 2006-11-29 |
| 1053497214 | County of Murray | General Acute Care Hospital | 2042 Juniper Ave, Slayton, MN 56172-1017 | 2006-10-31 |
| 1699879833 | Unity Family Healthcare | General Acute Care Hospital | 300 3rd Ave, Albany, MN 56307-9363 | 2006-09-08 |
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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.