Candice Lou Vanderplaats, RN CNP
Individual provider Active NPI Family Nurse Practitioner · Tyler, MN
NPI 1104178946 · NPPES record last updated Apr 3, 2017
Key facts
- NPI
- 1104178946
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R172256-5 (MN)
- Practice address
- 240 Willow Street
Tyler, MN 56178 - Phone
- (507) 247-5921
- Fax
- (507) 247-5184
- NPI assigned
- Oct 3, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rural Health Care Inc
Practice addresses (Care Compare)
1216 Ryans Rd
Suite 3
Worthington, MN 56187-1781
Phone (507) 372-6522
1521 Carlson St
Suite 100
Marshall, MN 56258-2626
Phone (507) 473-4800
Hospital & facility affiliations
- Avera at Home Marshall
- Avera Marshall Regional Medical Ctr
- Avera Granite Falls
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121231000044 | MN | Practitioner - Nurse Practitioner | 7416100334 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R172256-5 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera Tyler | Family | Current |
Accepting new patients |
| Avera Tyler | Current |
Accepting new patients | |
| Avera Marshall | Current | Accepting new patients | |
| Rural Health Care, Inc | Nurse Practitioner | Current | Accepting new patients |
| Avera Tyler | Current | Accepting new patients | |
| Avera Marshall | Current |
Accepting new patients | |
| Avera Marshall | Current |
Accepting new patients | |
| Rural Health Care, Inc | Current |
Accepting new patients | |
| Rural Health Care, Inc | Current |
Accepting new patients | |
| Avera Marshall | Past | Accepting new patients | |
| Healthpartners, Inc. | Past | Accepting new patients | |
| Saint Francis Medical Center | Nurse Practitioner | Past | Accepting new patients |
| Rural Health Care, Inc. | Past | Accepting new patients | |
| Virtuwell Medical Services, P.C. | Past | Accepting new patients |
Locations
109 E Benton St
Lake Benton, MN 56149
Phone (507) 368-4323
1521 Carlson St
Marshall, MN 56258
Phone (507) 532-1101
300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631
300 S Bruce St
Ste 100
Marshall, MN 56258
1521 Carlson St
Ste 100
Marshall, MN 56258
Phone (507) 476-4800
1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522
1216 Ryans Rd
Worthington, MN 56187
Phone (507) 372-2921
Interoperability endpoints
- candice.vanderplaats@avera.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R172256-5 | MN | Yes |
Addresses
Primary practice location
240 Willow Street
Tyler, MN 56178
Mailing address
240 Willow Street
Tyler, MN 56178
Phone (507) 247-5921
Other providers in Tyler, MN
- Thrifty Drug Stores Inc
- Tyler Family Dental PLLC
- Tyler Healthcare Center Dba Tyler Healthcare Pharmacy
- Marissa Rae Tyler
- John Rice Utoft
- Luann Elizabeth Weber
- Kristal Sue Wilmes
All providers in Tyler, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.