AVERA MARSHALL (NPI# 1588005961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588005961 |
| Entity Type | Organization |
| Organization Name | AVERA MARSHALL |
| Other Organization Name | AVERA MEDICAL GROUP REDWOOD FALLS |
| Practice Address |
506 E Bridge St Redwood Falls MN 56283-1168 |
| Practice Telephone | 5076277537 |
| Mailing Telephone | 5076277537 |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |
| Authorized Official Name | SHARON WILLIAMS (V.P. OF FINANCE) |
| Authorized Official Telephone | 5075379150 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 019545600 | 05 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Redwood Falls | 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 |
506 E BRIDGE ST |
| City | REDWOOD FALLS |
| State | MN |
| Zip Code | 56283-1168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548229313 | Rebecca Louann Carol Simonsen | Nurse Practitioner | 506 E Bridge St, Redwood Falls, MN 56283-1168 | 2006-03-21 |
| 1962887885 | Kilee Tauer | Physician Assistant | 506 E Bridge St, Redwood Falls, MN 56283-1168 | 2015-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073128153 | Michael W Flinn Dds, Pa | Dentist | 200 Firewood Drive, Redwood, MN 56283 | 2020-09-15 |
| 1851763932 | Thomas A Bruns | Nurse Anesthetist, Certified Registered | 30057 700th Avenue, Redwood Falls, MN 56283 | 2015-10-28 |
| 1073905881 | Cindy Moldan | Registered Nurse | 100 Fallwood Road, Redwood Area Hospital, Redwood Falls, MN 56283 | 2015-03-03 |
| 1922329903 | Amanda J Kittelson | Physician Assistant | Carris Health-redwood, 100 Fallwood Road, Redwood Falls, MN 56283 | 2010-06-14 |
| 1356474183 | Timothy Shane Brown | Dentist | 105 E Bridge St, Redwood Falls, MN 56283 | 2007-03-13 |
| 1356484513 | Sward-kemp Drug Co Inc | Pharmacy | 207 South Washington Street, Redwood Falls, MN 56283 | 2007-02-15 |
| 1699782169 | Janet L Marti | Nurse Practitioner | 1100 E. Broadway, Affiliated Community Medical Centers, Redwood Falls, MN 56283 | 2006-08-01 |
| 1124094842 | Cynthia K Gronau | Family Medicine | 1100 E Broadway, Redwood Falls, MN 56283 | 2006-02-23 |
| 1063493781 | Thomas C. Gross | Emergency Medicine | 1100 East Broadway, Affiliated Community Medical Centers, Redwood Falls, MN 56283 | 2005-11-09 |
| 1457872434 | Susan Buckley | Physical Therapist | 100 Fallwood Road, Redwood Area Hospital, Redwood Falls, MN 56283 | 2017-06-29 |
| Find all providers in zip 56283 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| Find all providers with the same taxonomy | ||||
| City | REDWOOD FALLS |
| Zip Code | 56283 |
Please comment or provide details below to improve the information on AVERA MARSHALL.
| 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.