AVERA ST LUKES


Address: 310 S Penn St, Suite 105, Aberdeen, SD 57401
Phone: 6056228700

AVERA ST LUKES (NPI# 1780004713) 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) 1780004713
Entity Type Organization
Organization Name AVERA ST LUKES
Other Organization Name AVERA MEDICAL GROUP RADIATION ONCOLOGY ABERDEEN
Practice Address 310 S Penn St
Suite 105
Aberdeen
SD 57401
Mailing Address Po Box 1460
Aberdeen
SD 57402-1460
Practice Telephone 6056228700
Practice Fax Number 6056225042
Mailing Telephone 6056222857
Mailing Fax Number 6056222859
Enumeration Date 2014-04-17
Last Update Date 2020-04-02
Authorized Official Name DEBBIE STREIER (VICE PRESIDENT)
Authorized Official Telephone 6056222807
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0001X Radiology
Specialization: Radiation Oncology
SD Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SD MEDICARE S101808 01

Other Provider/Organization Names

Other Name Type Code
Avera Medical Group Radiation Oncology Aberdeen Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1932203015 Avera St Lukes Internal Medicine 201 S Lloyd St Ste W240, Aberdeen, SD 57401-4530 2006-09-11
1174548937 Avera St Lukes Radiology 1400 10th Ave W, Mobridge, SD 57601-1246 2006-07-13
1386693430 Avera St Lukes Skilled Nursing Facility 1002 N Jay St, Aberdeen, SD 57401-2439 2006-05-08
1831504711 Avera St Lukes Clinic/Center 310 S Penn St, Ste 201, Aberdeen, SD 57401 2014-06-30
1386738102 Avera St Lukes Pharmacy 305 S State St, Aberdeen, SD 57401-4527 2006-10-03
1912011867 Avera St Lukes Prosthetic/Orthotic Supplier 305 S State St, Aberdeen, SD 57401-4527 2006-08-18
1760423057 Avera St Lukes Clinic/Center 240 Main St, Ellendale, ND 58436 2006-06-09
1013968940 Avera St Lukes Medicare Defined Swing Bed Unit 305 S State St, Aberdeen, SD 57401-4527 2006-05-15
1003867029 Avera St Lukes Psychiatric Hospital 305 S State St, Aberdeen, SD 57401-4527 2006-05-15
1649221664 Avera St Lukes Clinic/Center 305 S State St, Aberdeen, SD 57401-4527 2006-05-15

Office Location

Street Address 310 S PENN ST
SUITE 105
City ABERDEEN
State SD
Zip Code 57401

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851394662 Richard J Conklin Internal Medicine 310 S Penn St, Suite 105, Aberdeen, SD 57401-4553 2005-05-24
1407309057 Chelsea R Westerman Nurse Practitioner 310 S Penn St, Suite 204, Aberdeen, SD 57401-4553 2016-08-01
1831504711 Avera St Lukes Clinic/Center 310 S Penn St, Ste 201, Aberdeen, SD 57401 2014-06-30
1912265489 Avera St. Luke's Internal Medicine 310 S Penn St, Ste 203, Aberdeen, SD 57401 2012-05-02
1720376825 Christopher L Nelson Nurse Practitioner 310 S Penn St, Suite 105, Aberdeen, SD 57401-4553 2011-07-11
1669769998 Shanna M. Anderson Nurse Practitioner 310 S Penn St, Suite 203, Aberdeen, SD 57401-4553 2011-07-07
1154641595 Charles L. Pelton Jr. Physician Assistant 310 S Penn St, Suite 202, Aberdeen, SD 57401-4553 2010-06-08
1720317118 Avera St. Luke's Obstetrics & Gynecology 310 S Penn St, Suite 204, Aberdeen, SD 57401 2009-12-14
1780815506 Avera St. Luke's Neurological Surgery 310 S Penn St, Suite 203, Aberdeen, SD 57401 2009-07-28
1295990141 Christopher M Larson Surgery 310 S Penn St, Suite 201, Aberdeen, SD 57401-4553 2008-07-21
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2085R0001X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Radiation Oncology

Taxonomy Definition

A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578794715 Troy Edward Adolfson Radiology 620 3rd Ave Se, Aberdeen, SD 57401-4554 2009-08-06
1659487999 Enrique Flores Mendoza Radiology 305 S State St, Aberdeen, SD 57401 2006-08-21

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1396067948 Ronald G Drummond Radiology 1910 Highwood Road, Rapid City, SD 57701 2010-02-24
1760625768 Kyle Owen Arneson Radiology 1000 E 23rd St Ste 100, Sioux Falls, SD 57105-2114 2009-04-07
1346339777 Michael E Peterson Md PC Radiology 605 N Foster, Mitchell, SD 57301-2902 2006-10-12
1336238757 Michael E Peterson Radiology 1115 W 9th St, Yankton, SD 57078-3310 2006-10-12
1568427144 Stephen Dick Radiology 605 N Foster St, Mitchell, SD 57301-2902 2006-04-18
1457347007 Daniel Martin Tackett Radiology 3751 Skyline Dr, Rapid City, SD 57701-5363 2005-09-20
1962927269 Avera Queen of Peace Radiology 605 N Foster St, Mitchell, SD 57301-2902 2017-08-08
1346529211 Sanford Clinic Radiology 1309 W 17th St, Sioux Falls, SD 57104-4663 2011-08-10
1477847861 Avera Mckennan Radiology 1000 E. 23rd St., Ste. 100, Sioux Falls, SD 57105-2113 2011-06-03
1710270061 Joel L Grow Radiology 1000 E 23rd St Ste 100, Sioux Falls, SD 57105-2114 2011-05-19
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Competitor

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City ABERDEEN
Zip Code 57401

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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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