AVERA TYLER (NPI# 1821042920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821042920 |
| Entity Type | Organization |
| Organization Name | AVERA TYLER |
| Other Organization Name | AVERA SUNRISE MANOR |
| Practice Address |
240 Willow St Tyler MN 56178-1166 |
| Practice Telephone | 5072475521 |
| Practice Fax Number | 5072475972 |
| Mailing Telephone | 5072475521 |
| Mailing Fax Number | 5072475972 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | MRS. SHARON ANN WILLIAMS (VP OF FINANCE) |
| Authorized Official Telephone | 5075379150 |
| Is Organization Subpart | Y |
| Parent Organization Name | AVERA TYLER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 376918 | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 599245100 | 05 | |
| MN | BLUE CROSS | 1889NAL | 01 |
| Other Name | Type Code |
|---|---|
| Avera Sunrise Manor | 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 |
| 1063949089 | Avera Tyler | Nurse Practitioner | 312 E George St, Ivanhoe, MN 56142-9707 | 2017-05-22 |
| 1326102237 | Avera Tyler | Medicare Defined Swing Bed Unit | 240 Willow Street, Tyler, MN 56178 | 2006-12-22 |
| 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 |
240 WILLOW ST |
| City | TYLER |
| State | MN |
| Zip Code | 56178-1166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174501159 | Enrico Ocampo | Internal Medicine | 240 Willow St, Tyler, MN 56178-1166 | 2006-01-09 |
| 1467927657 | Travis Erickson | Nurse Practitioner | 240 Willow St, Tyler, MN 56178-1201 | 2018-10-04 |
| 1003392911 | Gail Beck | Occupational Therapy Assistant | 240 Willow St, Tyler, MN 56178-1201 | 2018-07-13 |
| 1669906053 | Michelle Reynolds | Family Medicine | 240 Willow St, Tyler, MN 56178-1201 | 2017-04-12 |
| 1134563653 | Christopher Stephen Reynolds | Family Medicine | 240 Willow St, Tyler, MN 56178-1201 | 2013-04-26 |
| 1235186230 | Richard L Klingler | Family Medicine | 240 Willow St, Tyler, MN 56178-1166 | 2006-05-27 |
| 1649223439 | Avera Tyler | Clinic/Center | 240 Willow St, Tyler, MN 56178-0240 | 2006-05-19 |
| 1104870948 | Edward B Novak | Family Medicine | 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 |
| 1225081474 | Robert William Tatreau | Family Medicine | 240 Willow St, Tyler, MN 56178 | 2006-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689180259 | Align Family Chiropractic LLC | Chiropractor | 117 W Hughes Street, Tyler, MN 56178 | 2017-12-19 |
| 1639235971 | John Rice Utoft | Dentist | 197 North Tyler St, Tyler, MN 56178 | 2006-12-29 |
| 1154415172 | April Rose Hanson | Pharmacist | 240 Willow Street, Tyler, MN 56178 | 2006-10-03 |
| 1285676874 | Koster Pharmacy | Pharmacy | 183 N Tyler St, Tyler, MN 56178 | 2006-06-11 |
| 1104178946 | Candice Lou Vanderplaats | Nurse Practitioner | 240 Willow Street, Tyler, MN 56178 | 2012-10-03 |
| 1184832891 | Tyler Healthcare Center Dba Tyler Healthcare Pharmacy | General Acute Care Hospital | 240 Willow St., Tyler, MN 56178 | 2007-05-18 |
| 1326102237 | Avera Tyler | Medicare Defined Swing Bed Unit | 240 Willow Street, Tyler, MN 56178 | 2006-12-22 |
| 1285687004 | Luann Elizabeth Weber | Physician Assistant | 240 Willow St., Tyler, MN 56178-0240 | 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 |
| Find all providers in zip 56178 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396291969 | The Center At Grande, LLC | Skilled Nursing Facility | 3219 East Grande Blvd, Tyler, TX 75707 | 2016-09-01 |
| 1972902245 | Titus County Hospital District | Skilled Nursing Facility | 3505 Old Jacksonvil Rd, Tyler, TX 75701-8510 | 2014-08-22 |
| 1104249317 | Rehab Pro Lp | Skilled Nursing Facility | 17521 Us Highway 69 S Ste 120, Tyler, TX 75703-5376 | 2014-01-23 |
| 1801228986 | Touchstone Strategies - Tyler LLC | Skilled Nursing Facility | 2650 Elkton Trl, Tyler, TX 75703-0580 | 2013-07-31 |
| 1790004679 | Touchstone Strategies, LLC | Skilled Nursing Facility | 2650 Elkton Trail, Tyler, TX 75703 | 2010-05-18 |
| 1255654133 | Sears Tyler Methodist Retirement Corporation | Skilled Nursing Facility | 16044 County Road 165, Tyler, TX 75703-7302 | 2010-03-08 |
| 1982886578 | Hsmtx Waterton Plaza, LLC | Skilled Nursing Facility | 2875 Shiloh Rd, Tyler, TX 75703-2936 | 2007-12-05 |
| 1477694545 | Azalea Place Operating Company | Skilled Nursing Facility | 810 S Porter Ave, Tyler, TX 75701-2300 | 2007-02-09 |
| 1629135975 | Park Place Tyler Healthcare, LLC | Skilled Nursing Facility | 2450 E 5th St, Tyler, TX 75701-3525 | 2007-01-03 |
| 1477610814 | Melrose Hcc, LLC | Skilled Nursing Facility | 1501 W 29th St, Tyler, TX 75702-1404 | 2007-01-03 |
| Find all providers in TYLER | ||||
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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.