Individual provider Active NPI

Terry L Evers, APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Maple Grove, MN
National Provider Identifier
1194042663
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP104 Issued in MN
Practice address
11334 86TH Ave N
Maple Grove, MN 55369-4528
Phone
(763) 233-8127
NPI assigned
Apr 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X R171736-3 MN
Family Nurse Practitioner 363LF0000X R-171736-3 MN
Family Nurse Practitioner 363LF0000X R171736-3 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11074-33 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP104 MN Primary

Addresses

Primary practice location

11334 86TH Ave N
Maple Grove, MN 55369-4528

Mailing address

N4857 Gusk Rd
Taylor, WI 54659-7001
Phone (763) 233-8127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-171736-3MNMDFamily Nurse Practitioner
R171736-3MNMDFamily Nurse Practitioner
CNP104MNMDPsychiatric/Mental Health Nurse Practitioner
11074-33WIMDPsychiatric/Mental Health Nurse Practitioner
104MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Woodwinds Hospital CurrentSince Dec 12, 2015 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Dec 12, 2015 Accepting new patients
Healtheast Care System CurrentSince Dec 12, 2015 Accepting new patients
Hiawatha Valley Mental Health Center CurrentSince Apr 17, 2023 Accepting new patients
Black River Health Inc CurrentSince Jun 1, 2021 Accepting new patients
Nystrom & Associates, LTD CurrentSince Jan 13, 2020 Accepting new patients
Fairview Bethesda Hospital CurrentSince Dec 12, 2015 Accepting new patients
Black River Health Inc CurrentSince Jun 1, 2021 Accepting new patients
Hiawatha Valley Mental Health Center Inc. CurrentSince Apr 17, 2023 Accepting new patients

Locations

13045 Falcon Dr
#100
Brainerd, MN 56425
Phone (218) 203-6282

221 S Kingston St
Caledonia, MN 55921
Phone (507) 725-2022

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

611 Broadway Ave
Ste 100
Wabasha, MN 55981
Phone (651) 565-2234

420 E Sarnia St
Ste 2100
Winona, MN 55987
Phone (507) 454-4341

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1194042663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N4857 GUSK RD",
            "city": "TAYLOR",
            "state": "WI",
            "postal_code": "546597001",
            "telephone_number": "763-233-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11334 86TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694528",
            "telephone_number": "763-233-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERS",
        "first_name": "TERRY",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2024-05-15",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R171736-3",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R-171736-3",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R171736-3",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "11074-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "CNP104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.