AVERA ST. LUKE'S (NPI# 1912265489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912265489 |
| Entity Type | Organization |
| Organization Name | AVERA ST. LUKE'S |
| Other Organization Name | AVERA MEDICAL GROUP PULMONOLOGY ABERDEEN |
| Practice Address |
310 S Penn St Ste 203 Aberdeen SD 57401 |
| Mailing Address |
Po Box 1460 Aberdeen SD 57402-1460 |
| Practice Telephone | 6056222685 |
| Practice Fax Number | 6056222686 |
| Mailing Telephone | 6056222857 |
| Mailing Fax Number | 6056222859 |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2018-08-16 |
| Authorized Official Name | DEBBIE STREIER (VICE PRESIDENT) |
| Authorized Official Telephone | 6056222807 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Pulmonology 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 |
| 1891073003 | Avera St. Luke's | Anesthesiology | 305 S State St, Aberdeen, SD 57401 | 2011-07-22 |
| 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 |
310 S PENN ST STE 203 |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401 |
| 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 |
| 1780004713 | Avera St Lukes | Radiology | 310 S Penn St, Suite 105, Aberdeen, SD 57401 | 2014-04-17 |
| 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 |
| 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 | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932203015 | Avera St Lukes | Internal Medicine | 201 S Lloyd St Ste W240, Aberdeen, SD 57401-4530 | 2006-09-11 |
| 1124023361 | Richard W Felt | Internal Medicine | 1006 North H Street, Aberdeen, WA 98520 | 2005-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386610004 | Avera Mckennan | Internal Medicine | 1301 S. Cliff Ave., Ste. 601, Sioux Falls, SD 57105-1032 | 2006-02-23 |
| 1639327885 | Mohammad Hassan Alsumrain | Internal Medicine | 640 Flormann St, Rapid City, SD 57701-4679 | 2008-08-29 |
| 1942483797 | Debbie Anne Chiu Qua | Internal Medicine | 1205 S Grange Ave, Ste 407, Sioux Falls, SD 57105-0407 | 2007-12-14 |
| 1205018363 | Noel Dexter Luis Tiangco | Internal Medicine | 1301 S Cliff Ave, Ste 601, Sioux Falls, SD 57105-1032 | 2007-11-30 |
| 1336201953 | Javier E Bogarin | Internal Medicine | 353 Fairmont Blvd, Rapid City, SD 57701-7375 | 2006-12-14 |
| 1265457964 | Sanford Clinic | Internal Medicine | 1205 S Grange Ave, Ste 407, Sioux Falls, SD 57105-0410 | 2006-07-13 |
| 1972530442 | Elmo J Rosario | Internal Medicine | 2805 5th St, Suite 100, Rapid City, SD 57701 | 2006-06-28 |
| 1821025552 | Thomas Shull Lemire | Internal Medicine | 353 Fairmont Blvd., Rapid City, SD 57701 | 2006-06-27 |
| 1295770568 | Daniel Y Rawson | Internal Medicine | 640 Flormann St, Rapid City, SD 57701-4679 | 2006-06-19 |
| 1407895113 | James D Mccafferty | Internal Medicine | 640 Flormann St, Rapid City, SD 57701-4679 | 2006-06-06 |
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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.