AVERA TYLER (NPI# 1992759674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992759674 |
| Entity Type | Organization |
| Organization Name | AVERA TYLER |
| Other Organization Name | TYLER HOME CARE |
| 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 | 2006-05-19 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | MS. JULIE K. ST. AUBIN (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 5075379161 |
| Is Organization Subpart | Y |
| Parent Organization Name | AVERA TYLER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | ========= | MN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS | 1889ATY | 01 |
| MN | 599245100 | 05 |
| Other Name | Type Code |
|---|---|
| Tyler Home Care | 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 |
| 1821042920 | Avera Tyler | Skilled Nursing Facility | 240 Willow St, Tyler, MN 56178-1166 | 2006-05-22 |
| 1649223439 | Avera Tyler | Clinic/Center | 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 |
| 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 |
| 1821042920 | Avera Tyler | Skilled Nursing Facility | 240 Willow St, Tyler, MN 56178-1166 | 2006-05-22 |
| 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 |
| 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 | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831797760 | New Creative In Home Care | Home Health | 6011 Wilshire Dr, Tyler, TX 75703-4162 | 2020-10-13 |
| 1821588906 | Gerald Langston | Home Health | 1731 S Beckham Ave, Tyler, TX 75701-4436 | 2018-05-15 |
| 1942709464 | Rose Elia | Home Health | 5130 Chadbourne St, Tyler, TX 75703-5609 | 2018-02-10 |
| 1669994471 | Lhcg Cxii, LLC | Home Health | 821 E Southeast Loop 323 Ste 560, Tyler, TX 75701-9667 | 2017-07-13 |
| 1578085635 | Civplus Care LLC | Home Health | 4200 Old Omen Rd Apt 2202, Tyler, TX 75707-2146 | 2017-07-11 |
| 1285174292 | Heaton Health Services Agency LLC | Home Health | 1820 Shiloh Rd Ste 1503, Tyler, TX 75703-2459 | 2017-02-24 |
| 1952846628 | Spero Healthcare Services | Home Health | 6003 Old Bullard Rd, 145, Tyler, TX 75703-4235 | 2017-01-04 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1356731376 | Pf Total Adult & Beauty Health Agency | Home Health | 11408 Hwy 64 W, Tyler, TX 75704-6928 | 2015-01-29 |
| 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.