AVERA QUEEN OF PEACE (NPI# 1689051682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689051682 |
| Entity Type | Organization |
| Organization Name | AVERA QUEEN OF PEACE |
| Other Organization Name | AVERA ADVANCED PHYSICAL THERAPY |
| Practice Address |
409 S Ohlman St Mitchell SD 57301-3106 |
| Practice Telephone | 6059964552 |
| Practice Fax Number | 6059960577 |
| Mailing Telephone | 6059964552 |
| Mailing Fax Number | 6059960577 |
| Enumeration Date | 2015-04-29 |
| 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 | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Avera Advanced Physical Therapy | 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 |
| 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 |
| Street Address |
409 S OHLMAN ST |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-3106 |
| 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 |
| Find all providers in zip 57301 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073649901 | Dpt Inc | Clinic/Center | 1319 W Havens St, Mitchell, SD 57301-4116 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114453339 | High Plains Physical Therapy II LLC | Clinic/Center | 5610 Peaceful Pines Rd #4, Black Hawk, SD 57718-9253 | 2017-05-08 |
| 1083151468 | Milestones Pediatric Physical Therapy | Clinic/Center | 960 Nicole St, Rapid City, SD 57701-7047 | 2017-01-24 |
| 1386036119 | Betina K Basso | Clinic/Center | 13621 Neck Yoke Rd, Rapid City, SD 57702-7324 | 2015-03-03 |
| 1700146396 | Avera Mckennan | Clinic/Center | 1035 South Highline Pl, Ste #4, Sioux Falls, SD 57110 | 2012-05-17 |
| 1346494697 | Avera Mckennan | Clinic/Center | 103 N Splitrock Blvd, Brandon, SD 57005-1529 | 2008-11-13 |
| 1568509289 | Performance Physical Therapy Prof | Clinic/Center | 215 E Jackson Blvd, Suite B, Spearfish, SD 57783-2176 | 2007-01-31 |
| 1952334013 | Howard Physical Therapy, PC | Clinic/Center | 131 South Main St., Howard, SD 57349 | 2006-07-09 |
| 1083616536 | Hart Physical Therapy Inc | Clinic/Center | 50 Minnesota St, Suite 2, Rapid City, SD 57701-6217 | 2005-08-15 |
| 1922642016 | Prairie Performance Physical Therapy & Fitness, LLC | Clinic/Center | 510 1st St E, Buffalo, SD 57720 | 2019-10-31 |
| 1457823403 | Regional Health Physicians, Inc. | Clinic/Center | 1635 Caregiver Circle, Rapid City, SD 57702-8529 | 2018-12-31 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on AVERA QUEEN OF PEACE.
| 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.