Avera Marshall
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Marshall, MN
NPI 1154856839 · NPPES record last updated Dec 1, 2022
Key facts
- NPI
- 1154856839
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- AVERA MARSHALL
- Practice address
- 300 S Bruce St Ste D
Marshall, MN 56258-1934 - Phone
- (507) 537-9200
- NPI assigned
- May 1, 2017
- Organization subpart
- No
Authorized official
- Name
- Debbie Streier
- Title
- Ceo
- Phone
- (507) 537-9160
Owned or controlled facilities with NPI records 8
Other NPIs with the same Medicare PAC ID 13
Corporate family (same tax ID) 15
Practitioners 102
-
Amanda F Beranek, OTR
-
Jacob Peder Bollman, O.D.
-
Shannon Lea Brewers, LICSW
-
Troy Charles Bruns, D.N.P
-
Kelly Jean Ritter Brunsvold, MS,CCC-SLP
-
Matthew R Casey, MD
-
Jerry Durfee, CRNA
-
Neil Thomas Eichten, SLP
-
Chantelle Alice Lou Fieber, FNP-C
-
Glenn Alan Gaunt, M.D.
-
Jaci Rae Hannasch, CNP
-
Justin Garett Hartman, D.O.
-
Jeffrey A Horak, MD
-
Martin Heinz Janning, M.D.
-
John R. K. Kass, PA-C
-
Jason D Klein, CRNA, MS
-
Jessica Landsman, AUD
Affiliated clinicians 1
-
Lu Y Huber, MD
Medicare Care Compare: Dialysis facility
- Listed as
- Avera Dialysis Marshall
- Overall star rating
- ★★★★☆ 4.0 of 5
- Ownership
- Non-profit
- Certified
- Aug 10, 2018
- Medicare certification status
- Active
- Dialysis stations
- 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Avera Tyler Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Mar 1, 2016 Mar 1, 2016 |
| Avera Tyler Hospital |
Hospital | Operational/Managerial Control | Mar 1, 2016 |
| Avera Granite Falls Health Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jan 1, 2020 Jan 1, 2020 |
| Avera Granite Falls Health Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jan 1, 2020 Jan 1, 2020 |
| Avera Sunrise Manor |
Skilled nursing facility | Operational/Managerial Control | Feb 17, 2016 |
| Avera Granite Falls Care Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2020 |
| Avera Medical Group Tyler |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Mar 1, 2016 Mar 1, 2016 |
| Avera Medical Group Tyler |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Mar 1, 2016 Mar 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180330000475 | MN | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 5799695227 | Practice locations: Marshall, MN |
National Provider Directory
- Tax ID family
- Weiner Memorial Medical
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
300 S Bruce St Ste D
Marshall, MN 56258-1934
Mailing address
300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 532-9661
Other names
- Avera Dialysis Marshall
Other providers in Marshall, MN
- Chrissy Archbold
- Joyce Arends
- Lexis Arnold
- Avera Home Medical Equipment LLC
- Avera Marshall
- Avera Marshall
- Avera Marshall
- Avera Marshall
- Avera Marshall
- Avera Marshall
All providers in Marshall, MN · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2022. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.