| Carris Health Llc | |
|
301 Becker Ave Sw Willmar MN 56201-3302 | |
| (320) 235-4543 | |
| (320) 231-4971 |
| Full Name | Carris Health Llc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 301 Becker Ave Sw, Willmar, Minnesota |
| Authorized Official Name and Position | Michael Blair (CFO) |
| Authorized Official Contact | 3202555665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carris Health Llc 301 Becker Ave Sw Willmar MN 56201-3302 Ph: (320) 235-4543 | Carris Health Llc 301 Becker Ave Sw Willmar MN 56201-3302 Ph: (320) 235-4543 |
| NPI Number | 1134632680 |
|---|---|
| Provider Enumeration Date | 11/07/2017 |
| Last Update Date | 01/28/2021 |
| Certification Date | 01/28/2021 |
| Medicare PECOS PAC ID | 7012274228 |
|---|---|
| Medicare Enrollment ID | O20180111000831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134632680 | NPI | - | NPPES |
| Provider Name | John E Mertz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346217874 PECOS PAC ID: 2769396373 Enrollment ID: I20031118000430 |
| Provider Name | Andrew A Hoffmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457374035 PECOS PAC ID: 1658273644 Enrollment ID: I20040121000723 |
| Provider Name | John M Tate |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134141708 PECOS PAC ID: 6002703303 Enrollment ID: I20040302000416 |
| Provider Name | Liaqat A Sabir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083659288 PECOS PAC ID: 6901893270 Enrollment ID: I20040428000957 |
| Provider Name | Todd M Severnak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790775393 PECOS PAC ID: 2567452410 Enrollment ID: I20040513001105 |
| Provider Name | Steven J Fuglestad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083694897 PECOS PAC ID: 7214908011 Enrollment ID: I20040804001341 |
| Provider Name | Jeffrey L Reichel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104896406 PECOS PAC ID: 1658345160 Enrollment ID: I20040820001008 |
| Provider Name | Raymond A Watts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972533263 PECOS PAC ID: 4981651809 Enrollment ID: I20050404000355 |
| Provider Name | Joseph Michael Mayland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679505093 PECOS PAC ID: 6709813306 Enrollment ID: I20050726000399 |
| Provider Name | Benjamin B Ranstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376565325 PECOS PAC ID: 3971522400 Enrollment ID: I20051115000068 |
| Provider Name | Mark William Bonneville |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336129626 PECOS PAC ID: 7315967585 Enrollment ID: I20051202000162 |
| Provider Name | Larry Burton Okerlund |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881630051 PECOS PAC ID: 3476598012 Enrollment ID: I20060105000780 |
| Provider Name | Mohammed I Hussain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770557225 PECOS PAC ID: 6507871928 Enrollment ID: I20060207000251 |
| Provider Name | Jonathan R Sande |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1316970536 PECOS PAC ID: 2163438433 Enrollment ID: I20060223000160 |
| Provider Name | Craig John Bergh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780649715 PECOS PAC ID: 5890705917 Enrollment ID: I20060504000026 |
| Provider Name | Mevan N Wijetunga |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1457308645 PECOS PAC ID: 3072521640 Enrollment ID: I20060818000028 |
| Provider Name | Debra J Helseth |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194810168 PECOS PAC ID: 8224035928 Enrollment ID: I20061020000552 |
| Provider Name | Joseph Scuderi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043292253 PECOS PAC ID: 7517957988 Enrollment ID: I20070830000695 |
| Provider Name | Mohammad J Ranginwala |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1356329247 PECOS PAC ID: 2961597356 Enrollment ID: I20071001000102 |
| Provider Name | Sunn Sunn Htet Thaw |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1629277785 PECOS PAC ID: 8123115862 Enrollment ID: I20071029000190 |
| Provider Name | Charles Wolfe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376594457 PECOS PAC ID: 6901994979 Enrollment ID: I20071109000123 |
| Provider Name | Kevin J Cockerill |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1710963202 PECOS PAC ID: 2860581378 Enrollment ID: I20071207000251 |
| Provider Name | Chung K Lee |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1972609360 PECOS PAC ID: 5193815108 Enrollment ID: I20071214000053 |
| Provider Name | Kimberly J Haycraft-williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306800107 PECOS PAC ID: 7810073855 Enrollment ID: I20080331000428 |
| Provider Name | Aimee L Tebrake |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1467558197 PECOS PAC ID: 5193884070 Enrollment ID: I20081106000633 |
| Provider Name | Nelson L Adamson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1720155336 PECOS PAC ID: 1557425691 Enrollment ID: I20090204000156 |
| Provider Name | Alan R Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841359023 PECOS PAC ID: 3678630159 Enrollment ID: I20090327000269 |
| Provider Name | Debra G Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326000241 PECOS PAC ID: 0840341921 Enrollment ID: I20090701000110 |
| Provider Name | Jessica R Baitani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285800466 PECOS PAC ID: 6507912334 Enrollment ID: I20090921000434 |
| Provider Name | David A Newcomer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619943438 PECOS PAC ID: 5395833750 Enrollment ID: I20100109000302 |
| Provider Name | Alan J Roiseland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275553117 PECOS PAC ID: 1254317795 Enrollment ID: I20100111000676 |
| Provider Name | John M Schmitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982653499 PECOS PAC ID: 1153428248 Enrollment ID: I20100121000555 |
| Provider Name | Jane K Willett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548236292 PECOS PAC ID: 4789727769 Enrollment ID: I20100130000350 |
| Provider Name | Steven J Shelver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750357067 PECOS PAC ID: 8426191156 Enrollment ID: I20100203000778 |
| Provider Name | Darin D Willardsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346230034 PECOS PAC ID: 5395880462 Enrollment ID: I20100302000141 |
| Provider Name | Thomas G Schrup |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811988769 PECOS PAC ID: 8628970720 Enrollment ID: I20100315000177 |
| Provider Name | Jackie L Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023086568 PECOS PAC ID: 5991833949 Enrollment ID: I20100512000344 |
| Provider Name | Ann T Mcintosh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487615100 PECOS PAC ID: 4688703457 Enrollment ID: I20100603000905 |
| Provider Name | Leslee J Jaeger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346286838 PECOS PAC ID: 4082738208 Enrollment ID: I20100825000300 |
| Provider Name | Shih-an Hsieh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003076290 PECOS PAC ID: 1557485497 Enrollment ID: I20100830001137 |
| Provider Name | Duane Eric Westberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578577656 PECOS PAC ID: 4688790496 Enrollment ID: I20100929001425 |
| Provider Name | Richard A Wehseler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609842335 PECOS PAC ID: 3476745274 Enrollment ID: I20101012001040 |
| Provider Name | Michael K Butts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235102039 PECOS PAC ID: 6406044759 Enrollment ID: I20101230000640 |
| Provider Name | Julie V Bechtel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669638581 PECOS PAC ID: 5294762829 Enrollment ID: I20110217000244 |
| Provider Name | Miriam V Ragab |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356335467 PECOS PAC ID: 0749294114 Enrollment ID: I20111202000114 |
| Provider Name | Tod W Speer |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1245397231 PECOS PAC ID: 6002912995 Enrollment ID: I20120628000081 |
| Provider Name | Ryan R Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427374123 PECOS PAC ID: 7719150242 Enrollment ID: I20130722000201 |
| Provider Name | Jayme L Vanbeek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518246826 PECOS PAC ID: 2062653751 Enrollment ID: I20130723000214 |
| Provider Name | Angela L Beyerl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457793531 PECOS PAC ID: 5496989634 Enrollment ID: I20131002000031 |
| Provider Name | Keith E Furzland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497198733 PECOS PAC ID: 4183859630 Enrollment ID: I20131108001338 |
| Provider Name | Stephanie J Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760810493 PECOS PAC ID: 6608003215 Enrollment ID: I20131205000715 |
| Provider Name | Larry V Hook |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780909168 PECOS PAC ID: 6800059833 Enrollment ID: I20140623000545 |
| Provider Name | Kruti J Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043574262 PECOS PAC ID: 7012232218 Enrollment ID: I20150210002426 |
| Provider Name | Catherine R Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841382850 PECOS PAC ID: 7012232945 Enrollment ID: I20150217000547 |
| Provider Name | Kelly A Taunton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275923914 PECOS PAC ID: 2264750140 Enrollment ID: I20150407000235 |
| Provider Name | Eric David Hyun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831450170 PECOS PAC ID: 8527374388 Enrollment ID: I20150825004478 |
| Provider Name | Robert L Gonzalez |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285003608 PECOS PAC ID: 9032427786 Enrollment ID: I20150930001761 |
| Provider Name | Katherine Brooks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891895256 PECOS PAC ID: 8921098302 Enrollment ID: I20160121001963 |
| Provider Name | Paula A Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992876726 PECOS PAC ID: 4082658042 Enrollment ID: I20160210001720 |
| Provider Name | Howard L Russell |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1013938752 PECOS PAC ID: 9335313469 Enrollment ID: I20160420000686 |
| Provider Name | Theodora Anagnostou |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1780026567 PECOS PAC ID: 7214226612 Enrollment ID: I20160524000819 |
| Provider Name | Christopher B Miller |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1114201514 PECOS PAC ID: 7911145982 Enrollment ID: I20160715002167 |
| Provider Name | Anna V Perelshteyn |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1659699536 PECOS PAC ID: 7012203219 Enrollment ID: I20160915000104 |
| Provider Name | Brianna J Rick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831518448 PECOS PAC ID: 5597983320 Enrollment ID: I20161026002776 |
| Provider Name | Angie L Paschke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518410612 PECOS PAC ID: 2466732789 Enrollment ID: I20161202001222 |
| Provider Name | Daniel Falvey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003194085 PECOS PAC ID: 3678798758 Enrollment ID: I20161207000024 |
| Provider Name | Charlsie C Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609198761 PECOS PAC ID: 2668500620 Enrollment ID: I20161209000237 |
| Provider Name | Jason D Rasmussen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932657665 PECOS PAC ID: 1456631464 Enrollment ID: I20161209000277 |
| Provider Name | Addison Chan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568791994 PECOS PAC ID: 8729272216 Enrollment ID: I20170622002895 |
| Provider Name | Megan Hodges |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1831535863 PECOS PAC ID: 7416226550 Enrollment ID: I20170706000767 |
| Provider Name | Alexandra G Hartley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467831669 PECOS PAC ID: 2961795067 Enrollment ID: I20170712000459 |
| Provider Name | Alicia Grace Floyd |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033408505 PECOS PAC ID: 2567680713 Enrollment ID: I20170814001669 |
| Provider Name | Mahakit Inklab |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1124229869 PECOS PAC ID: 3577613355 Enrollment ID: I20171116000091 |
| Provider Name | Veronica E Radigan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740643105 PECOS PAC ID: 2264724715 Enrollment ID: I20180611001459 |
| Provider Name | Pavan K Bhamidipati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548490840 PECOS PAC ID: 9931358256 Enrollment ID: I20180616000010 |
| Provider Name | Lee M Haggenjos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003207416 PECOS PAC ID: 6709144892 Enrollment ID: I20180801002195 |
| Provider Name | Ryan Michael Finn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558898684 PECOS PAC ID: 7810269008 Enrollment ID: I20180806003180 |
| Provider Name | Paul Perry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043448095 PECOS PAC ID: 4284888462 Enrollment ID: I20180807002336 |
| Provider Name | Mark J Zarzycki |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215972930 PECOS PAC ID: 9830156991 Enrollment ID: I20180830003528 |
| Provider Name | Vaughan R Cipperly |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942235429 PECOS PAC ID: 6608764493 Enrollment ID: I20180830003678 |
| Provider Name | Brittany H Olmscheid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952887531 PECOS PAC ID: 4486905155 Enrollment ID: I20180919000574 |
| Provider Name | Sarah Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043785199 PECOS PAC ID: 2668726456 Enrollment ID: I20181114001061 |
| Provider Name | Harvey R Langee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801818042 PECOS PAC ID: 8820040546 Enrollment ID: I20190207000362 |
| Provider Name | Megan J Schumann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144874157 PECOS PAC ID: 1153659479 Enrollment ID: I20190826000076 |
| Provider Name | Sakshi Kaul |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1184044067 PECOS PAC ID: 6305141169 Enrollment ID: I20191002000804 |
| Provider Name | Jeffery D Barlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043248701 PECOS PAC ID: 8123259256 Enrollment ID: I20200521001926 |
| Provider Name | Kristi L Dreyer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285601856 PECOS PAC ID: 0446470702 Enrollment ID: I20200609002455 |
| Provider Name | Jennifer L Keating |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295231447 PECOS PAC ID: 2264789817 Enrollment ID: I20200625001664 |
| Provider Name | Chelsey R Paulson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891308813 PECOS PAC ID: 6305250317 Enrollment ID: I20210203001769 |
| Provider Name | David O Oladele-bankole |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083670087 PECOS PAC ID: 9335046887 Enrollment ID: I20210422000151 |
| Provider Name | John R Weis |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1912097502 PECOS PAC ID: 1658311394 Enrollment ID: I20210701000550 |
| Provider Name | Amber M Olson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003377649 PECOS PAC ID: 3577899152 Enrollment ID: I20210816000040 |
| Provider Name | Janelle Marie Thoreson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245906395 PECOS PAC ID: 4981001518 Enrollment ID: I20210924001580 |
| Provider Name | Michelle Olson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1770723868 PECOS PAC ID: 1254570039 Enrollment ID: I20211119000586 |
| Provider Name | Rebecca Jarratt Petersen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306403183 PECOS PAC ID: 6103152756 Enrollment ID: I20220308000702 |
| Provider Name | Janaya J Evenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083371884 PECOS PAC ID: 4284029075 Enrollment ID: I20220314000950 |
| Provider Name | Justin G Hammar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427437102 PECOS PAC ID: 9335453653 Enrollment ID: I20220504000946 |
| Provider Name | Bashir S Moallin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144840463 PECOS PAC ID: 6608299821 Enrollment ID: I20220510002368 |
| Provider Name | Lisa N Angell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760142046 PECOS PAC ID: 8325425838 Enrollment ID: I20220520002055 |
| Provider Name | Brennan Weber |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265882807 PECOS PAC ID: 9830469980 Enrollment ID: I20220711001885 |
| Provider Name | Seth D Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679193957 PECOS PAC ID: 4486076973 Enrollment ID: I20220718001182 |
| Provider Name | Courtney A Bothun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700515582 PECOS PAC ID: 9931580834 Enrollment ID: I20220725001199 |
| Provider Name | Abdikafar M Yusuf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366935363 PECOS PAC ID: 4385067503 Enrollment ID: I20220818002946 |
| Provider Name | Sarah Margaret Campbell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538789631 PECOS PAC ID: 6709200371 Enrollment ID: I20221010001075 |
| Provider Name | Nicholas A Cook-rostie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386225720 PECOS PAC ID: 5193128825 Enrollment ID: I20221213001294 |
| Provider Name | Emily Felzenberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063684702 PECOS PAC ID: 5890872329 Enrollment ID: I20221222002211 |
| Provider Name | Cassandra R Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053998781 PECOS PAC ID: 7517369309 Enrollment ID: I20230103000017 |
| Provider Name | Jonathon Robert Swan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811468630 PECOS PAC ID: 3779907670 Enrollment ID: I20230111000942 |
| Provider Name | Jayson Vincent Singson Lingan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326364902 PECOS PAC ID: 5395037097 Enrollment ID: I20230123001057 |
| Provider Name | Megan Ann Woller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801500400 PECOS PAC ID: 1153792205 Enrollment ID: I20230127000781 |
| Provider Name | Ami J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740455138 PECOS PAC ID: 2567836521 Enrollment ID: I20230315002281 |
| Provider Name | Katharine Hannah Vincent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760994644 PECOS PAC ID: 8820358070 Enrollment ID: I20230330002221 |
| Provider Name | Matthew Peterson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730475351 PECOS PAC ID: 6608009006 Enrollment ID: I20230421000117 |
| Provider Name | Ivy May Debruycker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265136360 PECOS PAC ID: 9335504570 Enrollment ID: I20230424000835 |
| Provider Name | Nicholas Olson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1558704338 PECOS PAC ID: 0840596169 Enrollment ID: I20230512002500 |
| Provider Name | Lois Teston |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1437174935 PECOS PAC ID: 7113918640 Enrollment ID: I20230525000771 |
| Provider Name | Katherine Abigail Moberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902595606 PECOS PAC ID: 5991162299 Enrollment ID: I20230601000071 |
| Provider Name | Jeanne Jiyoung Min |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174827984 PECOS PAC ID: 6507224516 Enrollment ID: I20230623001487 |
| Provider Name | Mintcho Mintchev |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043673395 PECOS PAC ID: 2163781485 Enrollment ID: I20230627002021 |
| Provider Name | Nayyar Siddique |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1497890610 PECOS PAC ID: 3577634369 Enrollment ID: I20230710000620 |
| Provider Name | Paul Gonzales |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770962888 PECOS PAC ID: 6406123066 Enrollment ID: I20230721001823 |
| Provider Name | Grace C Caldwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285216788 PECOS PAC ID: 4082016860 Enrollment ID: I20230818001221 |
| Provider Name | Emily A Mammenga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245810217 PECOS PAC ID: 5799187589 Enrollment ID: I20230920002599 |
| Provider Name | Erica North |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376118364 PECOS PAC ID: 8022411065 Enrollment ID: I20230927001078 |
| Provider Name | Thomas I. Sweet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164581732 PECOS PAC ID: 5991875841 Enrollment ID: I20231020001079 |
| Provider Name | Natasha Mae Fester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851170237 PECOS PAC ID: 9739535691 Enrollment ID: I20231028000084 |
| Provider Name | Tamra Jean Jensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346022100 PECOS PAC ID: 9739536327 Enrollment ID: I20231102003577 |
| Provider Name | Mussie Asmerom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285094433 PECOS PAC ID: 5496040024 Enrollment ID: I20231122002153 |
| Provider Name | Nicholas Teneyuque |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790002376 PECOS PAC ID: 4688056682 Enrollment ID: I20231122003013 |
| Provider Name | Jeffrey T Hunt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245641760 PECOS PAC ID: 9931401478 Enrollment ID: I20240102001117 |
| Provider Name | Herbert Duvivier |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1710982731 PECOS PAC ID: 6800889742 Enrollment ID: I20240129001591 |
| Provider Name | Rishi Seth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962790832 PECOS PAC ID: 0840411658 Enrollment ID: I20240216002329 |
Carroll Psychological Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 4th St Sw, Willmar, MN 56201 Phone: 320-214-7733 | |
Woodland Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1125 6th St Se, Willmar, MN 56201 Phone: 320-235-4613 Fax: 320-231-9140 | |
Nolan's Place Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 19th Ave Sw, Willmar, MN 56201 Phone: 320-403-5247 Fax: 320-403-5249 | |
Glacier Lakes Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2313 6th Ave Se, Willmar, MN 56201 Phone: 612-963-5889 | |
Community Outreach Counseling Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1617 Highway 12 E, Suite 230, Willmar, MN 56201 Phone: 320-905-0795 Fax: 320-205-0030 | |
Grateful Heart Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 115 Litchfield Ave Se Ste 202, Willmar, MN 56201 Phone: 320-522-1411 |