NPIMap

Organization Active NPI

Avera Marshall

Doing business as Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
National Provider Identifier
1568401016
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
331067 Issued in MN
Legal business name
AVERA MARSHALL
Doing business as
Avera Marshall Regional Medical Center
Practice address
300 S Bruce St
Marshall, MN 56258-1934
Phone
(507) 532-9661
NPI assigned
Jun 6, 2006
Last updated
Dec 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Debbie Streier
Title
Ceo
Phone
(507) 537-9160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 331067 MN Primary

Addresses

Primary practice location

300 S Bruce St
Marshall, MN 56258-1934

Mailing address

300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 532-9661

Other identifiers 1

IdentifierTypeStateIssuer
019545600MedicaidMN

Other names 1

  • Avera Marshall Regional Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031106000219 MN Part B Supplier - Clinic/Group Practice 5799695227 Receives reassigned benefits from 278 practitioners
18 other NPIs on this enrollment
Practice locations: Tracy, MN; Springfield, MN; Dawson, MN; Redwood Falls, MN; Minneota, MN; Marshall, MN; Eden Prairie, MN; Canby, MN…
O20091209000435 MN Part A Provider - Critical Access Hospital 5799695227 Receives reassigned benefits from 147 practitioners
Practice locations: Marshall, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568401016. Details of each certification follow.

Hospital certification: CCN 241359

Legal name
AVERA MARSHALL
Doing business as
AVERA MARSHALL REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2004
Last certification
Mar 11, 2016
Beds
49 (25 certified)
Ownership / control type
Private (not for profit)
Most recent change of ownership
Nov 2, 2009 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Dec 26, 1944 in MN
Enrollment address
300 S Bruce St
Marshall, MN 56258-1934
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Avera Marshall

    dba Avera@Home Southwest Minnesota

    • Home Health Agency
    • Marshall, MN
    • NPI 1033535547

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Dialysis Marshall

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Marshall, MN
    • NPI 1154856839

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Morningside Heights Care Center

    • Skilled Nursing Facility
    • Marshall, MN
    • NPI 1255329033

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Eye Care Dawson

    • Optometrist
    • Dawson, MN
    • NPI 1396513370

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Eye Care Tracy

    • Optometrist
    • Tracy, MN
    • NPI 1487958062

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Eye Care Marshall

    • Durable Medical Equipment & Medical Supplies
    • Marshall, MN
    • NPI 1669622031

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Marshall Regional Medical Center

    • Medicare Defined Swing Bed Hospital Unit
    • Marshall, MN
    • NPI 1700070430

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Marshall Regional Medical Center

    • Psychiatric Hospital Unit
    • Marshall, MN
    • NPI 1750508412

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Eye Care Springfield

    • Ophthalmology Physician
    • Springfield, MN
    • NPI 1922316041

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Eye Care Canby

    • Optometrist
    • Canby, MN
    • NPI 1952179939

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera@Home Southwest Minnesota

    • Community Based Hospice Care Agency
    • Marshall, MN
    • NPI 1952727463

    5799695227

    Same PAC ID
  • Avera Marshall

    dba Avera Marshall Specialty Clinic

    • Multi-Specialty Clinic/Center
    • Marshall, MN
    • NPI 1962641936

    5799695227

    Same PAC ID
View all 13

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

Care Compare: Hospital

Medicare Care Compare
Listed as
Avera Marshall Regional Medical CtrCCN 241359 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: alatza@avera.intellechartdirect.net
  • Direct secure messaging: clouwagie@avera.intellechartdirect.net
  • Direct secure messaging: ggrabenstein@avera.intellechartdirect.net
  • Direct secure messaging: gkouri@avera.intellechartdirect.net
  • Direct secure messaging: jries@avera.intellechartdirect.net
  • Direct secure messaging: lrockne@avera.intellechartdirect.net
  • Direct secure messaging: nhemmingson@avera.intellechartdirect.net
  • Direct secure messaging: rries@avera.intellechartdirect.net
  • Direct secure messaging: susan.boone@avera.sdhealthlink.net
  • Direct secure messaging: tkindle@avera.intellechartdirect.net
  • Direct secure messaging: travis.erickson@avera.sdhealthlink.net

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James Francis Dover Individual Corporate OfficerFache, President/Ceo Avera Health Oct 23, 2023
Jill Vroman Individual Corporate DirectorBoard Member Jul 1, 2023
Debra Ann Streier Individual Corporate OfficerCeo Feb 1, 2021
Tim O'Leary Individual Corporate DirectorBoard Member Jul 1, 2023
Jodelle a Zimmerman Individual Corporate DirectorBoard Member Jul 1, 2018
Amanda Marie Schutz Individual Corporate OfficerVP Patient Financial Services Jun 1, 2018
W-2 Managing EmployeeVP Patient Financial Services Jun 1, 2018
Sharon Hennen Individual Corporate DirectorBoard Member Jul 1, 2023
Amanda Sieling Individual Corporate DirectorBoard Member Jul 1, 2018
Karie Engle Novak Individual Corporate DirectorBoard Member Jul 1, 2024
Lavonne Annette Koenen Individual Corporate DirectorBoard Member Jul 1, 2020
Julie Lautt Individual Corporate OfficerCfo Mar 1, 2020
Thomas Matthew Lorang Individual Corporate DirectorBoard Member Jul 1, 2024
Curtis Ronald Louwagie Individual Corporate DirectorBoard Member Jul 1, 2018
Avera Health Organization, Sioux Falls, SD Non-profit 5% Or Greater Direct Ownership Interest Nov 2, 2009 100%
Rhonda J Wiering Individual Corporate DirectorBoard Member Mar 1, 2025

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avera Tyler HospitalTyler, MN, CCN 241348 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Mar 1, 2016
Mar 1, 2016
Avera Tyler HospitalTyler, MN, CCN 24Z348 Hospital Operational/Managerial Control Mar 1, 2016
Avera Granite Falls Health CenterGranite Falls, MN, CCN 241343 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2020
Jan 1, 2020
Avera Granite Falls Health CenterGranite Falls, MN, CCN 24Z343 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2020
Jan 1, 2020
Avera Sunrise ManorTyler, MN, CCN 245357 Skilled nursing facility Operational/Managerial Control Feb 17, 2016
Avera Granite Falls Care CenterGranite Falls, MN, CCN 245243 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2020
Avera Medical Group TylerTyler, MN, CCN 243413 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Mar 1, 2016
Mar 1, 2016
Avera Medical Group TylerLake Benton, MN, CCN 243470 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Mar 1, 2016
Mar 1, 2016

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Avera Granite Falls

    dba Avera Granite Falls Health Center Swingbed

    • Medicare Defined Swing Bed Hospital Unit
    • Granite Falls, MN
    • NPI 1578106498

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Avera Granite Falls

    dba Avera Granite Falls Care Center

    • Skilled Nursing Facility
    • Granite Falls, MN
    • NPI 1679116503

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Avera Granite Falls

    dba Avera Granite Falls Health Center

    • Critical Access Hospital
    • Granite Falls, MN
    • NPI 1700429610

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Avera Tyler

    dba Avera Lake Benton Clinic

    • Rural Health Clinic/Center
    • Lake Benton, MN
    • NPI 1003869892

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Avera Tyler
    • Medicare Defined Swing Bed Hospital Unit
    • Tyler, MN
    • NPI 1326102237

    Operational/Managerial Control

    CMS ownership
  • Avera Tyler

    dba Avera Medical Group Tyler

    • Rural Health Clinic/Center
    • Tyler, MN
    • NPI 1649223439

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Avera Tyler

    dba Avera Tyler Hospital

    • Critical Access Hospital
    • Tyler, MN
    • NPI 1801840517

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Avera Tyler

    dba Avera Sunrise Manor

    • Skilled Nursing Facility
    • Tyler, MN
    • NPI 1821042920

    Operational/Managerial Control

    CMS ownership

Facilities with the same owner 90

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 90

Practitioners & affiliated clinicians

Practitioners 304

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 304

Affiliated clinicians 248

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 248

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1568401016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S BRUCE ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581934",
            "telephone_number": "507-532-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S BRUCE ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581934",
            "telephone_number": "507-532-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MARSHALL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "STREIER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-537-9160"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "331067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019545600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Marshall Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Marshall Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marshall, MN

Sources for this page

Verify at the official NPI Registry.