AVERA QUEEN OF PEACE


Address: 605 N Foster St Ste 100, Mitchell, SD 57301-2902
Phone: (605) 995-5756

AVERA QUEEN OF PEACE (NPI# 1568986040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568986040
Entity Type Organization
Organization Name AVERA QUEEN OF PEACE
Other Organization Name AVERA MEDICAL GROUP ONCOLOGY & HEMATOLOGY MITCHELL
Practice Address 605 N Foster St Ste 100
Mitchell
SD 57301-2902
Mailing Address Po Box 432
Mitchell
SD 57301-0432
Practice Telephone (605) 995-5756
Practice Fax Number 6059955750
Mailing Telephone 6059956337
Mailing Fax Number 6059955779
Enumeration Date 2017-07-27
Last Update Date 2020-08-20
Authorized Official Name DOUGLAS EKEREN (PRESIDENT/CEO)
Authorized Official Telephone 6056688322
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SD MEDICARE S1639 01

Other Provider/Organization Names

Other Name Type Code
Avera Medical Group Oncology & Hematology Mitchell Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1689051682 Avera Queen of Peace Clinic/Center 409 S Ohlman St, Mitchell, SD 57301-3106 2015-04-29
1649577297 Avera Queen of Peace Clinic/Center 1900 Grassland Dr., Mitchell, SD 57301-6205 2011-02-17
1053557967 Avera Queen of Peace Physician Assistant 115 Second St Se, De Smet, SD 57231-0463 2008-12-23
1699972422 Avera Queen of Peace Specialist 625 N Foster St Ste 200, Mitchell, SD 57301-2968 2007-06-27
1992712921 Avera Queen of Peace Pharmacy 609 1st St Ne, Wessington Springs, SD 57382-2136 2006-08-02
1932105046 Avera Queen of Peace Clinic/Center 265 Main Street, Corsica, SD 57328 2005-06-23
1326043092 Avera Queen of Peace Clinic/Center 213 South Main, Howard, SD 57349 2005-06-17
1316942204 Avera Queen of Peace Clinic/Center 604 1st St Ne, Wessington Springs, SD 57382-2134 2005-06-16
1639174568 Avera Queen of Peace Clinic/Center 741 S Hill St, Salem, SD 57058-8761 2005-06-16
1144225129 Avera Queen of Peace Skilled Nursing Facility 500 S Ohlman St, Mitchell, SD 57301-3109 2005-06-16

Office Location

Street Address 605 N FOSTER ST STE 100
City MITCHELL
State SD
Zip Code 57301-2902

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932721388 Dakota Counseling Institute Social Worker 910 W Havens, Mitchell, SD 57301 2020-05-08
1215588512 Carolyn Marie Klinkhammer Registered Nurse 525 North Foster - Avera Queen of Peace Hospital, Mitchell, SD 57301 2019-09-27
1720596893 Brian Bannwarth Pharmacist 25147 Campground Road, Mitchell, SD 57301 2018-01-11
1336664135 Haley Long Speech-Language Pathologist 200 East Havens, Mitchell, SD 57301 2017-08-14
1770004996 Edgewood Mitchell LLC Assisted Living Facility 501 East Spruce Street, Mitchell, SD 57301 2017-06-28
1467831685 Amanda Louise Johnson Physical Therapist 910 S Edgerton, Mitchell, SD 57301 2015-05-20
1922432830 Melissa Jill Maier Dentist 240 E 23 Ave, Mitchell, SD 57301 2013-08-27
1356626972 Lewis Family Drug, LLC Pharmacy 1507 N Main St, Mitchell, SD 57301 2011-10-14
1184945958 Kimberly L Lienemann Counselor 403 N Lawler St, Mitchell, SD 57301 2010-06-16
1134365554 Gronsten-maier Dental Prof. LLC Dentist 240 E. 23rd Avenue, Mitchell, SD 57301 2009-01-07
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Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and state

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
1184935652 Houman Nourkeyhani Internal Medicine 1000 E 23rd St Ste 230, Sioux Falls, SD 57105-2122 2010-06-29
1518148535 Richard J Conklin, Md Internal Medicine 620 3rd Ave Se, Aberdeen, SD 57401-4507 2007-11-19
1124017256 Michael Stephen Mchale Internal Medicine 1000 E. 23rd St., Ste. 230, Sioux Falls, SD 57105-2122 2005-10-20
1275528382 Thomas B Tan Internal Medicine Rapid City Regional Hospital, 353 Fairmont Blvd., Rapid City, SD 57701 2005-09-14
1437155140 Miroslaw A Mazurczak Internal Medicine 1309 W 17th St, Ste 101, Sioux Falls, SD 57104-8805 2005-06-27
1851394662 Richard J Conklin Internal Medicine 310 S Penn St, Suite 105, Aberdeen, SD 57401-4553 2005-05-24
1457831497 Conklin Clinics, Prof LLC Internal Medicine 1409 6th Ave Se Ste 5, Aberdeen, SD 57401-4950 2018-08-20
1164780201 Avera Mckennan Internal Medicine 3720 W 69th St, Sioux Falls, SD 57108-8192 2012-04-26
1063787083 Rapid City Regional Hospital Inc Internal Medicine 353 Fairmont Blvd, Rapid City, SD 57701-7375 2012-03-09
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Competitor

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City MITCHELL
Zip Code 57301

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Dataset Information

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.

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