AVERA ST. LUKE'S (NPI# 1528255775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528255775 |
| Entity Type | Organization |
| Organization Name | AVERA ST. LUKE'S |
| Other Organization Name | AVERA MEDICAL GROUP ORTHOPEDICS ABERDEEN |
| Practice Address |
815 1st Ave Se Aberdeen SD 57401-4602 |
| Mailing Address |
Po Box 1460 Aberdeen SD 57402-1460 |
| Practice Telephone | 6056222570 |
| Practice Fax Number | 6056222571 |
| Mailing Telephone | 6056222857 |
| Mailing Fax Number | 6056222859 |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2011-06-15 |
| Authorized Official Name | MR. RON L JACOBSON (CEO AND PRESIDENT) |
| Authorized Official Telephone | 6056225230 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 10525 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 14555 | 05 | |
| SD | DAKOTACARE | 9251368 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Orthopedics Aberdeen | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336483551 | Avera St. Luke's | Internal Medicine | 310 S Penn St Ste 106, Aberdeen, SD 57401-4553 | 2012-11-15 |
| 1558624668 | Avera St. Luke's | Family Medicine | 501 Bloemendaal Drive, Ipswich, SD 57451 | 2012-06-22 |
| 1619273927 | Avera St. Luke's | Surgery | 4141 31st Ave S Ste 105, Fargo, ND 58104-8778 | 2011-02-03 |
| 1013143296 | Avera St. Luke's | Family Medicine | 105 S State St Ste 113, Aberdeen, SD 57401-4502 | 2009-06-02 |
| 1215100813 | Avera St. Luke's | Dietitian, Registered | 105 S State St Ste 201, Aberdeen, SD 57401-4502 | 2008-04-04 |
| 1154346625 | Avera St. Luke's | Family Medicine | 4401 Main St, Selby, SD 57472 | 2006-07-13 |
| 1124459391 | Avera St. Luke's | Orthopaedic Surgery | 701 8th Ave Nw, Aberdeen, SD 57401 | 2013-12-12 |
| 1982030177 | Avera St. Luke's | Physician Assistant | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2013-09-19 |
| 1083051817 | Avera St. Luke's | Anesthesiology | 815 1st Ave Se, Aberdeen, SD 57401 | 2013-06-03 |
| 1912265489 | Avera St. Luke's | Internal Medicine | 310 S Penn St, Ste 203, Aberdeen, SD 57401 | 2012-05-02 |
| 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 |
815 1ST AVE SE |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-4602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275515736 | Marie Quaschnick | Nurse Practitioner | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2005-11-18 |
| 1982030177 | Avera St. Luke's | Physician Assistant | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2013-09-19 |
| 1083051817 | Avera St. Luke's | Anesthesiology | 815 1st Ave Se, Aberdeen, SD 57401 | 2013-06-03 |
| 1386991412 | Olawunmi Aabiodun Lawal | Internal Medicine | 815 1st Ave Se, Suite 104, Aberdeen, SD 57401-4602 | 2012-08-08 |
| 1871869172 | Blake Anthony Heinz | Internal Medicine | 815 1st Ave Se, Suite 104, Aberdeen, SD 57401-4602 | 2012-03-30 |
| 1184893349 | Arlin Monroe Myrmoe | Internal Medicine | 815 1st Ave Se, Suite E104, Aberdeen, SD 57401-4602 | 2008-02-21 |
| 1770603888 | Shawna M. Schmidt | Anesthesiology | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2007-03-30 |
| 1588715064 | Kendall R. Goetz | Pharmacist | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2007-01-13 |
| 1407945918 | Lisa Beth Wurnig-johnson | Physician Assistant | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2006-10-12 |
| 1588752463 | Jennifer Joyce Daggett | Pharmacist | 815 1st Ave Se, #202, Aberdeen, SD 57401-4602 | 2006-10-10 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265401533 | Gregory Kenneth May | Orthopaedic Surgery | 1211 Skyview Dr, Aberdeen, WA 98520-1099 | 2006-03-17 |
| 1245236785 | Matthew C Reynen | Orthopaedic Surgery | 701 8th Avenue Nw Suite A, Aberdeen, SD 57401 | 2005-06-21 |
| 1124459391 | Avera St. Luke's | Orthopaedic Surgery | 701 8th Ave Nw, Aberdeen, SD 57401 | 2013-12-12 |
| 1538504832 | Thomas G. Harbert | Orthopaedic Surgery | 201 S Lloyd St, Suite 110, Aberdeen, SD 57401-4552 | 2013-05-01 |
| 1013252790 | Sanford Health Network | Orthopaedic Surgery | 701 8th Ave Nw, Aberdeen, SD 57401-1865 | 2012-12-06 |
| 1992974265 | Erin Aiko Kawasaki | Orthopaedic Surgery | 1211 Skyview Dr, Aberdeen, WA 98520 | 2008-02-21 |
| 1720151905 | Harbor Orthopedic and Fracture Clinic | Orthopaedic Surgery | 1211 Skyview Dr, Aberdeen, WA 98520-1099 | 2006-11-16 |
| 1427077106 | Brandon S. Fites | Orthopaedic Surgery | 701 8th Ave Nw Ste A, Aberdeen, SD 57401-1865 | 2006-07-19 |
| 1952353617 | Aberdeen Association of Orthopedic Surgeons | Orthopaedic Surgery | 201 S Lloyd St, Suite 110, Aberdeen, SD 57401-4552 | 2006-05-17 |
| 1144279555 | Patrick Miller | Orthopaedic Surgery | 701 8th Ave Nw Ste A, Aberdeen, SD 57401-1865 | 2006-05-10 |
| Find all providers in ABERDEEN | ||||
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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.