AVERA QUEEN OF PEACE (NPI# 1639174568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639174568 |
| Entity Type | Organization |
| Organization Name | AVERA QUEEN OF PEACE |
| Other Organization Name | AVERA MEDICAL GROUP SALEM |
| Practice Address |
741 S Hill St Salem SD 57058-8761 |
| Mailing Address |
525 N Foster St Mitchell SD 57301-2966 |
| Practice Telephone | 6054253038 |
| Practice Fax Number | 6054253039 |
| Mailing Telephone | 6059952000 |
| Mailing Fax Number | 6059952441 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-08-20 |
| Authorized Official Name | DOUGLAS EKEREN (PRESIDENT/CEO) |
| Authorized Official Telephone | 6056688322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
N/A | SD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | MEDICARE RR | CR0890 | 01 |
| SD | MEDICA | 00-00592 | 01 |
| SD | 5307012 | 05 | |
| SD | 5307010 | 05 | |
| SD | WELLMARK | 4998666 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Salem | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568986040 | Avera Queen of Peace | Internal Medicine | 605 N Foster St Ste 100, Mitchell, SD 57301-2902 | 2017-07-27 |
| 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 |
| 1144225129 | Avera Queen of Peace | Skilled Nursing Facility | 500 S Ohlman St, Mitchell, SD 57301-3109 | 2005-06-16 |
| Street Address |
741 S HILL ST |
| City | SALEM |
| State | SD |
| Zip Code | 57058-8761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619201829 | Avera Queen of Peace | Clinic/Center | 741 S Hill St, Salem, SD 57058-8761 | 2009-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265629471 | Amy Marie Heumiller | Occupational Therapist | 511 S. Nebraska, Salem, SD 57058 | 2007-10-02 |
| 1154463347 | Debra M Cheeseman | Chiropractor | 221 North Main St, Salem, SD 57058 | 2007-02-13 |
| 1750433355 | Cheeseman Chiropractic PC | Chiropractor | 221 N. Main St, Salem, SD 57058 | 2007-01-17 |
| 1790870186 | Bryan L. Schierholz | Pharmacist | 300 North Main Street, Salem, SD 57058 | 2006-10-03 |
| 1942233051 | Mccook County Emergency Medical Service Inc | Emergency Medical Technician, Paramedic | 400 S. Hill St., Salem, SD 57058 | 2006-07-09 |
| 1467759696 | Mccook Therapy | Clinic/Center | 511 S. Nebraska, Salem, SD 57058 | 2011-02-24 |
| 1356436844 | Salem Drug Incorporated | Pharmacist | 300 North Main Street, Salem, SD 57058 | 2006-10-03 |
| 1467438960 | William J Roth | Pharmacist | 300 N Main St, Salem, SD 57058 | 2005-12-16 |
| 1962615344 | Mccook County Dentalcenter,pc | Dentist | 440 East Rutan Avenue, Salem, SD 57058-0549 | 2007-05-08 |
| 1659584035 | Mary Ann Dick | Dentist | 440 East Rutan Avenue, Salem, SD 57058-0549 | 2007-05-08 |
| Find all providers in zip 57058 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679600936 | Ozarks Medical Center | Clinic/Center | 172 Hwy 62 East, Suite 1, Salem, AR 72576 | 2007-02-27 |
| 1821089657 | Salem Memorial Hospital | Clinic/Center | 35629 Highway 72 Bldg II, Salem, MO 65560-7217 | 2005-11-01 |
| 1649830472 | Salem Township Hospital | Clinic/Center | 1321 W Whittaker St, Salem, IL 62881-2013 | 2019-06-14 |
| 1316411655 | Crittenden Community Hospital LLC | Clinic/Center | 117 E Main St, Salem, KY 42078-9998 | 2019-01-21 |
| 1922345800 | Salem Memorial Hospital | Clinic/Center | 35629 Highway 72, Building 1, Salem, MO 65560-7217 | 2013-01-11 |
| 1194077701 | Pcrmc Medical Group, Inc | Clinic/Center | 1415 W Scenic Rivers Blvd, Salem, MO 65560-2840 | 2012-10-05 |
| 1023326436 | Lifeline Homecare of Salem LLC | Clinic/Center | 503 E Main St, Salem, KY 42078-8033 | 2010-09-20 |
| 1619201829 | Avera Queen of Peace | Clinic/Center | 741 S Hill St, Salem, SD 57058-8761 | 2009-09-22 |
| 1619109543 | Physician Services Corp of Southern Illinois | Clinic/Center | 1250 W Whittaker St, Salem, IL 62881-1917 | 2009-08-11 |
| 1821243981 | Salem Memorial Hospital | Clinic/Center | 35629 Hwy 72, Bld. 3, Salem, MO 65560-0719 | 2008-11-17 |
| Find all providers in SALEM | ||||
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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.