Peggy J Dykema, RN CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0753810 Issued in MN

Practice address

5234 Lawler Beach Rd
Willmar, MN 56201-9120

Phone

(320) 231-5000

Fax

(320) 231-5067

NPI assigned

Mar 3, 2006

Last updated

May 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Affiliated Community Medical Centers, LTD

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1952363699
  NPD
• Carris Health LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1598236408
  NPD

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1902873359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 W DIVISION ST",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013926",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5234 LAWLER BEACH RD",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562019120",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKEMA",
        "first_name": "PEGGY",
        "middle_name": "J",
        "credential": "RN CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R0753810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "595716100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicky Lynn Dunn, LADC
• Christian Duruji Sr., RPH
• Leah Ann Dvorak, DO
• Jan Marie Dworshak, CMT
• Cheryl Dybevik
• Heidi Eggers
• Shawna Lynn Nelson Ehlenbach, MSW LICSW
• Kya Elfering
• Amy Rillo Ellingson, M.D.
• Mickala Elliot

• Family Nurse Practitioner in Willmar, MN
• Providers in Willmar, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.