Marissa Rae Tyler, DC
Individual provider Active NPI Chiropractor · Tyler, MN
NPI 1891563458 · NPPES record last updated Dec 13, 2023
Key facts
- NPI
- 1891563458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 7153 (MN)
- Practice address
- 100 E Highway 14
Tyler, MN 56178-1101 - Phone
- (507) 247-3249
- NPI assigned
- Dec 13, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwest Family Chiropractic P.L.C.
Practice addresses (Care Compare)
100 E Hwy 14
Tyler, MN 56178-1101
Phone (507) 247-3249
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240717001598 | MN | Practitioner - Chiropractic | 2062957772 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Family Chiropractic P.L.C. | Chiropractor | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 7153 | MN | Yes |
Addresses
Primary practice location
100 E Highway 14
Tyler, MN 56178-1101
Mailing address
100 E Highway 14
Tyler, MN 56178-1101
Phone (507) 247-3249
Other providers in Tyler, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2023. 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.
- 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.