AVERA MARSHALL (NPI# 1407330301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407330301 |
| Entity Type | Organization |
| Organization Name | AVERA MARSHALL |
| Practice Address |
1521 Carlson St Marshall MN 56258-2626 |
| Practice Telephone | 5075329631 |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |
| Authorized Official Name | SHARON WILLIAMS (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 5075379150 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Carlson | 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 |
| 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 |
| 1033535547 | Avera Marshall | In Home Supportive Care | 1104 E College Dr, Marshall, MN 56258-4270 | 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 |
1521 CARLSON ST |
| City | MARSHALL |
| State | MN |
| Zip Code | 56258-2626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649246380 | Vincent D Laporte | Family Medicine | 1521 Carlson St, Marshall, MN 56258-2626 | 2006-02-23 |
| 1770062804 | Kasey Myers | Nurse Practitioner | 1521 Carlson St, Marshall, MN 56258-2626 | 2018-08-09 |
| 1851800510 | Amanda Paradis | Nurse Practitioner | 1521 Carlson St, Marshall, MN 56258-2626 | 2017-09-26 |
| 1609323484 | Amanda Kate Enestvedt | Nurse Practitioner | 1521 Carlson St, Marshall, MN 56258 | 2016-09-08 |
| 1659724516 | Jaclyn Victoria Parliament | Physical Therapist | 1521 Carlson St, Marshall, MN 56258-2626 | 2016-07-15 |
| 1962872994 | Bobbi Jo Vandendriessche | Nurse Practitioner | 1521 Carlson St, Marshall, MN 56258-2626 | 2015-10-02 |
| 1477520542 | Jason D Klein | Nurse Anesthetist, Certified Registered | 1521 Carlson St, Marshall, MN 56258-2626 | 2006-03-07 |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235639113 | Gillette Children's Specialty Healthcare | Clinic/Center | 300 S Bruce St, Marshall, MN 56258-1934 | 2018-02-16 |
| 1962641936 | Avera Marshall | Clinic/Center | 300 S Bruce St, Marshall, MN 56258-1934 | 2009-02-13 |
| 1487842662 | Hospital & Medical Foundation of Paris, Inc | Clinic/Center | 410 N 2nd St, Marshall, IL 62441-1010 | 2007-10-12 |
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| 1992224331 | Orthopedic & Sports Physical Therapy, Inc. | Clinic/Center | 322 N Tower Rd, Fergus Falls, MN 56537-1015 | 2017-09-18 |
| 1003339789 | Centracare Clinic | Clinic/Center | 2025 Stearns Way Ste 114, Saint Cloud, MN 56303 | 2017-07-25 |
| 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.