AVERA ST LUKES (NPI# 1013968940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013968940 |
| Entity Type | Organization |
| Organization Name | AVERA ST LUKES |
| Practice Address |
305 S State St Aberdeen SD 57401-4527 |
| Practice Telephone | 6056225000 |
| Practice Fax Number | 6056225255 |
| Mailing Telephone | 6056225000 |
| Mailing Fax Number | 6056225255 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RONALD L JACOBSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6056225125 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 10525 | SD | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 0159010 | 05 | |
| SD | HOSPITAL SWINGBED UNIT | 8U014 | 01 |
| ND | 01953 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932203015 | Avera St Lukes | Internal Medicine | 201 S Lloyd St Ste W240, Aberdeen, SD 57401-4530 | 2006-09-11 |
| 1174548937 | Avera St Lukes | Radiology | 1400 10th Ave W, Mobridge, SD 57601-1246 | 2006-07-13 |
| 1386693430 | Avera St Lukes | Skilled Nursing Facility | 1002 N Jay St, Aberdeen, SD 57401-2439 | 2006-05-08 |
| 1831504711 | Avera St Lukes | Clinic/Center | 310 S Penn St, Ste 201, Aberdeen, SD 57401 | 2014-06-30 |
| 1780004713 | Avera St Lukes | Radiology | 310 S Penn St, Suite 105, Aberdeen, SD 57401 | 2014-04-17 |
| 1386738102 | Avera St Lukes | Pharmacy | 305 S State St, Aberdeen, SD 57401-4527 | 2006-10-03 |
| 1912011867 | Avera St Lukes | Prosthetic/Orthotic Supplier | 305 S State St, Aberdeen, SD 57401-4527 | 2006-08-18 |
| 1760423057 | Avera St Lukes | Clinic/Center | 240 Main St, Ellendale, ND 58436 | 2006-06-09 |
| 1003867029 | Avera St Lukes | Psychiatric Hospital | 305 S State St, Aberdeen, SD 57401-4527 | 2006-05-15 |
| 1649221664 | Avera St Lukes | Clinic/Center | 305 S State St, Aberdeen, SD 57401-4527 | 2006-05-15 |
| Street Address |
305 S STATE ST |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-4527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790789543 | Russell C Pietz | Family Medicine | 305 S State St, Aberdeen, SD 57401-4527 | 2005-06-09 |
| 1942824701 | Stacy Lynn Anderson | Pharmacist | 305 S State St, Aberdeen, SD 57401-4527 | 2020-06-07 |
| 1124502646 | Avera St Luke's | Emergency Medicine | 305 S State St, Aberdeen, SD 57401-4527 | 2018-09-20 |
| 1689150252 | Kim Susanne Kram | Specialist/Technologist | 305 S State St, Aberdeen, SD 57401-4527 | 2018-07-17 |
| 1144769522 | Gerhard Marx | Social Worker | 305 S State St, Aberdeen, SD 57401-4527 | 2017-02-17 |
| 1851771133 | Susan Gutenkauf | Occupational Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-06-02 |
| 1538548649 | Melanie C Erickson | Occupational Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-05-21 |
| 1639557184 | Carrie Ann Werth | Occupational Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-05-15 |
| 1861870404 | Buckley D Norris | Occupational Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-05-15 |
| 1285012005 | Jason Stolp | Physical Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679002950 | Brenda Lee Pence | Registered Nurse | 305 S. State St., Aberdeen, SD 57401 | 2017-06-08 |
| 1104366475 | Jordan Shangreaux | Specialist/Technologist | 2200 S Roosevelt St, Aberdeen, SD 57401 | 2017-03-06 |
| 1205387545 | Midwest Medical Transport Company, LLC-aberdeen, Sd | Ambulance | 2919 Industrial Avenue, Aberdeen, SD 57401 | 2016-10-21 |
| 1356752471 | Cameron Eichler Enterprises | Hearing Aid Equipment | 110 6th Ave Se Ste 106, Aberdeen, SD 57401 | 2014-05-12 |
| 1184059412 | Richard Allen Ward IIi | Hearing Instrument Specialist | 1315 6th Avenue Se, Suite 4, Aberdeen, SD 57401 | 2013-09-05 |
| 1427395540 | Matthew William Svensen | Physical Therapist | 1109 S Jay St, Aberdeen, SD 57401 | 2013-01-09 |
| 1750655940 | Robert Ashly Froke | Audiologist | 121 4th Ave Sw-suite 1, Natural Hearing Center, Aberdeen, SD 57401 | 2012-03-06 |
| 1457504862 | Rodney S Johnson | Counselor | 14 S Main St Ste 1e, Aberdeen, SD 57401 | 2008-10-29 |
| 1518115005 | Dakota Chiropractic of Aberdeen, PC | Chiropractor | 520 Moccasin Drive, Aberdeen, SD 57401 | 2008-09-09 |
| 1558554626 | Tiffany Zimmerman Hoeft | Speech-Language Pathologist | 39515 Pintail Ave, Aberdeen, SD 57401 | 2007-08-22 |
| Find all providers in zip 57401 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710405741 | Boa Vida Hospital of Aberdeen, Ms, LLC | Medicare Defined Swing Bed Unit | 400 S Chestnut St, Aberdeen, MS 39730-3335 | 2017-08-30 |
| 1982121067 | Boa Vida Hospital of Aberdeen, Ms, LLC | Medicare Defined Swing Bed Unit | 400 S Chestnut St, Aberdeen, MS 39730-3335 | 2017-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992713457 | Avera St Marys | Medicare Defined Swing Bed Unit | 801 East Sioux Ave, Pierre, SD 57501-3323 | 2006-08-03 |
| 1265467245 | Pioneer Memorial Hospital & Health Services | Medicare Defined Swing Bed Unit | 315 N Washington Street, Viborg, SD 57070-0368 | 2006-07-11 |
| 1205803160 | Monument Health Network, Inc. | Medicare Defined Swing Bed Unit | 1220 Montgomery St, Custer, SD 57730-1705 | 2006-02-28 |
| 1861466898 | Monument Health Network, Inc. | Medicare Defined Swing Bed Unit | 1440 N Main St, Spearfish, SD 57783-1505 | 2006-02-15 |
| 1144292244 | City of Redfield | Medicare Defined Swing Bed Unit | 111 West 10th Ave, Redfield, SD 57469-1519 | 2006-02-02 |
| 1417215740 | Avera Mckennan | Medicare Defined Swing Bed Unit | 400 Park Ave, Gregory, SD 57533-1302 | 2012-04-24 |
| 1366611402 | Avera Mckennan | Medicare Defined Swing Bed Unit | 300 W 5th St, Miller, SD 57362-1238 | 2008-02-22 |
| 1255500534 | Avera Queen of Peace | Medicare Defined Swing Bed Unit | 306 Prairie Ave Sw, De Smet, SD 57231-2285 | 2008-02-21 |
| 1679635239 | Huron Regional Medical Center | Medicare Defined Swing Bed Unit | 306 Prairie Ave Sw, De Smet, SD 57231-2285 | 2006-12-13 |
| 1407918063 | Huron Regional Medical Center, Inc | Medicare Defined Swing Bed Unit | 172 4th St Se, Huron, SD 57350-2510 | 2006-12-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.