NPIMap

Individual provider Active NPI

Candice Lou Vanderplaats, RN CNP

  • Family Nurse Practitioner
  • Tyler, MN
National Provider Identifier
1104178946
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R172256-5 Issued in MN
Practice address
240 Willow Street
Tyler, MN 56178
Phone
(507) 247-5921
Fax
(507) 247-5184
NPI assigned
Oct 3, 2012
Last updated
Apr 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R172256-5 MN Primary

Addresses

Primary practice location

240 Willow Street
Tyler, MN 56178

Mailing address

240 Willow Street
Tyler, MN 56178
Phone (507) 247-5921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121231000044 MN Practitioner - Nurse Practitioner 7416100334 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1880MNMDMental Health Counselor
R172256-5MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Tyler CurrentSince Mar 1, 2016 Accepting new patients
Avera Tyler Family CurrentSince Mar 1, 2016 Accepting new patients
Rural Health Care, Inc CurrentSince Jan 1, 2022 Accepting new patients
Rural Health Care, Inc Nurse Practitioner Current Accepting new patients
Avera Marshall CurrentSince Sep 11, 2021 Accepting new patients
Avera Marshall Current Accepting new patients
Rural Health Care, Inc CurrentSince Jan 1, 2022 Accepting new patients
Avera Tyler Current Accepting new patients
Avera Marshall CurrentSince Sep 11, 2021 Accepting new patients
Tyler Healthcare Center Dba Tyler Healthcare Pharmacy Past Accepting new patients
Saint Francis Medical Center Nurse Practitioner Past Accepting new patients
Group Health, Inc. Past Accepting new patients
Rural Health Care, Inc. Past Accepting new patients
Avera Marshall 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

1521 Carlson St
Ste 100
Marshall, MN 56258
Phone (507) 476-4800

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

300 S Bruce St
Ste 100
Marshall, MN 56258

1216 Ryans Rd
Worthington, MN 56187
Phone (507) 372-2921

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

Interoperability endpoints

  • Direct secure messaging: candice.vanderplaats@avera.sdhealthlink.net

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1104178946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WILLOW STREET",
            "city": "TYLER",
            "state": "MN",
            "postal_code": "56178",
            "telephone_number": "507-247-5921",
            "fax_number": "507-247-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLOW STREET",
            "city": "TYLER",
            "state": "MN",
            "postal_code": "56178",
            "telephone_number": "507-247-5921",
            "fax_number": "507-247-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERPLAATS",
        "first_name": "CANDICE",
        "middle_name": "LOU",
        "credential": "RN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R172256-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, MN

Sources for this page

Verify at the official NPI Registry.