STANLEY CYRIL WORM (NPI# 1518021120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518021120 |
| Entity Type | Individual |
| Full Name | STANLEY CYRIL WORM |
| Credential | PHYSICIAN EXTENDER R |
| Practice Address |
101 Willmar Ave Sw Affiliated Community Medical Centers Willmar MN 56201 |
| Mailing Address |
101 Willmar Ave Sw Acmc Willmar MN 56201 |
| Practice Telephone | 3202315000 |
| Practice Fax Number | 3202315067 |
| Mailing Telephone | 3202315000 |
| Mailing Fax Number | 3202315067 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 8968 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
101 WILLMAR AVE SW AFFILIATED COMMUNITY MEDICAL CENTERS |
| City | WILLMAR |
| State | MN |
| Zip Code | 56201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004514 | Gregory M Macik | Optometrist | 101 Willmar Ave Sw, Affiliated Community Medical Centers, Willmar, MN 56201 | 2005-06-28 |
| 1356956601 | Crystal Lynn Fleischhacker | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-09-14 |
| 1730798760 | Katherine Anderson | Pharmacist | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-07-27 |
| 1861015786 | Madalyn Marie Vohnoutka | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-05-27 |
| 1811526403 | Meagan A Hoflock | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-04-06 |
| 1124657150 | Carris Health LLC | Clinic/Center | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-04-02 |
| 1689209900 | Sophie Sharon Reecher | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-03-06 |
| 1285267922 | Kavitha Malango | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-02-21 |
| 1972147858 | Jamie Kalean Erickson | Pharmacist | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-11-04 |
| 1124660865 | Carris Health LLC | Durable Medical Equipment & Medical Supplies | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-10-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793472 | Sarah Erickson | Counselor | 2120 60th Ave N.w., Willmar, MN 56201 | 2020-09-01 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1154856524 | Mude Transportation Inc | Non-emergency Medical Transport (VAN) | 1712 Monongalia Ave Sw Ap1, Willmar, MN 56201 | 2017-04-24 |
| 1285025874 | Jill Fellows | Occupational Therapist | 611 5th St. Sw, Willmar, MN 56201 | 2015-02-18 |
| 1700294881 | Brenda Wiese | Counselor | 1617 Hwy 12 E, Suite 230, Willmar, MN 56201 | 2014-08-01 |
| 1275955932 | Courtney Regnier | Marriage & Family Therapist | 2320 E Hwy 12 Ste 2, Willmar, MN 56201 | 2014-01-15 |
| 1568732402 | Pamela Jean Kubesh | Social Worker | 328 Sw 3rd Street, Willmar, MN 56201 | 2012-01-10 |
| 1699931824 | Community Behavioral Health Hospital-willmar | Psychiatric Hospital | 1208 Olena Ave Se, Willmar, MN 56201 | 2008-08-07 |
| 1700053345 | Nathan Schrick | Marriage & Family Therapist | 513 Sw 5th Street, Box 1810, Willmar, MN 56201 | 2008-05-13 |
| 1831381680 | Joan M Blonigan Christianson | Chiropractor | 1101 S 1st Street, Willmar, MN 56201 | 2007-08-15 |
| Find all providers in zip 56201 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861015786 | Madalyn Marie Vohnoutka | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-05-27 |
| 1689209900 | Sophie Sharon Reecher | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-03-06 |
| 1720551351 | Rachel Lee Ohmann | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-01-07 |
| 1760966758 | Megan Katherine Murphy | Physician Assistant | 1801 19th Ave Sw, Willmar, MN 56201-4946 | 2018-09-17 |
| 1639698889 | Christopher Roisland | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2017-09-19 |
| 1326419862 | Angela Cherveny | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2015-10-09 |
| 1306246277 | Julia M Bates | Physician Assistant | 301 Becker Ave Sw, Willmar, MN 56201-3302 | 2014-08-28 |
| 1376806133 | Sarah F Pattison | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201 | 2012-06-18 |
| 1639491798 | Holly Marie Morales | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2010-02-17 |
| 1629245766 | Priscilla K Willander | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2008-05-08 |
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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.