AVERA ST LUKE'S (NPI# 1306031976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306031976 |
| Entity Type | Organization |
| Organization Name | AVERA ST LUKE'S |
| Other Organization Name | AVERA MEDICAL GROUP GROTON |
| Practice Address |
8 E Us Highway 12 Groton SD 57445-2176 |
| Mailing Address |
Po Box 1460 Aberdeen SD 57402-1460 |
| Practice Telephone | 6053974242 |
| Practice Fax Number | 6053974243 |
| Mailing Telephone | 6056222857 |
| Mailing Fax Number | 6056222859 |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2020-04-02 |
| Authorized Official Name | DEBBIE STREIER (VICE PRESIDENT) |
| Authorized Official Telephone | 6056222807 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 10525 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | DAKOTACARE | 9250989 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Groton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124163225 | Avera St Luke's | Assisted Living Facility | 1020 N Jay St, Aberdeen, SD 57401-2480 | 2007-02-20 |
| 1124502646 | Avera St Luke's | Emergency Medicine | 305 S State St, Aberdeen, SD 57401-4527 | 2018-09-20 |
| 1619355633 | Avera St Luke's | Speech-Language Pathologist | 805 1st Ave Se, Aberdeen, SD 57401 | 2015-05-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AVERA ST LUKE'S HOSPITAL | 305 S State, Aberdeen, SD 57401-4527 |
| Street Address |
8 E US HIGHWAY 12 |
| City | GROTON |
| State | SD |
| Zip Code | 57445-2176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235409426 | Sharon E Simon | Nurse Practitioner | 8 E Us Highway 12, Suite 2, Groton, SD 57445-2176 | 2012-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114355765 | Groton Community Transit, Inc. | Non-emergency Medical Transport (VAN) | 205 E 2nd Ave., Groton, SD 57445 | 2013-10-17 |
| 1205909017 | Joanne Carol Hairy Shirt | Social Worker | 40703 128 St, Groton, SD 57445 | 2006-11-17 |
| 1861478745 | Eric L Harry | Physician Assistant | 8 E Hwy 12, Groton, SD 57445 | 2005-12-21 |
| 1780774166 | Groton Chiropractic Clinic, P.C. | Clinic/Center | 1205 North 1st Street, Groton, SD 57445-0199 | 2006-10-13 |
| 1356431738 | Carol Jean Mcfarland-kutter | Chiropractor | 1205 North 1st. Street, Groton, SD 57445-0199 | 2006-10-13 |
| 1992859383 | Lori Louise Giedt | Pharmacist | 1205 N 1st St, Groton, SD 57445-0347 | 2007-01-22 |
| 1518001023 | Lori L Giedt | Pharmacy | 1205 N 1st St, Groton, SD 57445-0347 | 2007-02-16 |
| 1750467742 | Groton Area School District | Local Education Agency (LEA) | 125 East 4th Ave., Groton, SD 57445-0410 | 2006-10-31 |
| 1699960799 | Crystal Marie Waage | Speech-Language Pathologist | 716 N 2nd St, Groton, SD 57445-2166 | 2007-09-11 |
| 1790737336 | Ggnsc Groton LLC | Skilled Nursing Facility | 1106 N 2nd St, Groton, SD 57445-2172 | 2006-05-16 |
| Find all providers in zip 57445 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780197715 | Yvonne J Sinclair | Family Medicine | 65 Merlino Dr, Groton, CT 06340-3149 | 2017-11-13 |
| 1982045969 | Jonathan Casey Brown | Family Medicine | 395 Hazelnut Hill Rd, Groton, CT 06340-3208 | 2013-07-08 |
| 1336434430 | Manju Mahajan | Family Medicine | 788 Boston Rd, Groton, MA 01450-2056 | 2011-06-16 |
| 1790970937 | Peter Clark, Md, PC | Family Medicine | 220 W South St, Groton, NY 13073-1237 | 2007-09-11 |
| 1427037159 | Ahmad M Mehdi | Family Medicine | 100 Sykes St, Groton, NY 13073 | 2006-01-11 |
| 1558345918 | John Christopher Daniel | Family Medicine | Trout Ave Bldg 141, Naval Submarine Medical Research Laboratory, Groton, CT 06349-5900 | 2005-11-30 |
| 1114918828 | Paul David Seeman | Family Medicine | Route 12 Bldg 449 Professional Affairs, Naval Ambulatory Care Center, Groton, CT 06349-5600 | 2005-11-02 |
| 1710978739 | Joel Walter Larcombe | Family Medicine | Route 12 Bldg 449, Naval Ambulatory Care Center Attn Professional Affairs, Groton, CT 06349-5600 | 2005-10-31 |
| 1588984264 | Tisha N. Dickey | Family Medicine | 1 Forge Village Rd, Groton, MA 01450-2047 | 2010-06-04 |
| 1972730380 | William A Boller IIi | Family Medicine | 1 Wahoo Ave, Groton, CT 06349-2324 | 2009-06-12 |
| Find all providers in GROTON | ||||
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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.