AVERA QUEEN OF PEACE (NPI# 1932105046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932105046 |
| Entity Type | Organization |
| Organization Name | AVERA QUEEN OF PEACE |
| Other Organization Name | AVERA MEDICAL GROUP CORSICA |
| Practice Address |
265 Main Street Corsica SD 57328 |
| Mailing Address |
525 N Foster St Mitchell SD 57301-2966 |
| Practice Telephone | 6059465411 |
| Practice Fax Number | 6059465206 |
| Mailing Telephone | 6059952000 |
| Mailing Fax Number | 6059952441 |
| Enumeration Date | 2005-06-23 |
| 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 | WELLMARK | 0000018 | 01 |
| SD | MULTIPLAN | A-87545 | 01 |
| SD | 5306742 | 05 | |
| SD | 5306743 | 05 | |
| SD | MEDICA | 00-00435 | 01 |
| SD | MEDICARE RR | CR0890 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Corsica | 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 |
| 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 |
265 MAIN STREET |
| City | CORSICA |
| State | SD |
| Zip Code | 57328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952635492 | Avera Queen of Peace | Clinic/Center | 265 Main Street, Corsica, SD 57328 | 2009-10-01 |
| 1710957188 | Nathan Hinker | Nurse Practitioner | 265 Main Street, Corsica, SD 57328-0028 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255347464 | Douglas County Memorial Hospital | Pharmacy | 265 E Main St, Corsica, SD 57328 | 2006-07-31 |
| 1194712984 | Tamara Vanroekel | Pharmacist | 230 E. Main St, Corsica, SD 57328 | 2005-10-05 |
| 1043702244 | Nicole Lynn Bamberg | Nurse Practitioner | 265 E Main St, Corsica, SD 57328 | 2018-06-04 |
| 1003879958 | Douglas County Memorial Hospital | Clinic/Center | 230 Main St, Corsica, SD 57328 | 2006-04-11 |
| 1285957803 | Kristen K Bittner | Pharmacist | 230 E Main Street, Corsica, SD 57328-0022 | 2010-03-10 |
| 1609085513 | Craig Haiar | Pharmacist | 265 E Main St, Corsica, SD 57328-0114 | 2007-05-21 |
| 1831180462 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 455 N Dakota Ave, Corsica, SD 57328-2110 | 2005-11-02 |
| 1710442314 | Brady Allen Seiler | Physical Therapist | 455 N Dakota Ave, Corsica, SD 57328-2110 | 2019-02-07 |
| 1417412206 | Shaina Lonneman | Physical Therapist | 455 N Dakota Ave, Corsica, SD 57328-2110 | 2019-02-05 |
| 1447715636 | Maria Lynn Vosika | Speech-Language Pathologist | 455 N Dakota Ave, Corsica, SD 57328-2110 | 2019-02-01 |
| Find all providers in zip 57328 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952635492 | Avera Queen of Peace | Clinic/Center | 265 Main Street, Corsica, SD 57328 | 2009-10-01 |
| 1003879958 | Douglas County Memorial Hospital | Clinic/Center | 230 Main St, Corsica, SD 57328 | 2006-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447803432 | City of Brookings | Clinic/Center | 104 1/2 West 2nd Street, Elkton, SD 57026 | 2019-07-19 |
| 1477942878 | Platte Community Memorial Hospital, Inc | Clinic/Center | 306 S Johnston St, White Lake, SD 57383-2251 | 2015-01-22 |
| 1003230541 | Regional Health Physicians, Inc. | Clinic/Center | 112 7th Avenue, Wall, SD 57790 | 2014-02-04 |
| 1912279829 | City of Brookings | Clinic/Center | 302 E 5th Street, White, SD 57276-2061 | 2012-02-08 |
| 1902187032 | Community Memorial Hospital Inc | Clinic/Center | 314 Mellette St, Bonesteel, SD 57317 | 2011-09-02 |
| 1609013317 | Douglas County Memorial Hospital | Clinic/Center | 310 W Sd Highway 46, Wagner, SD 57380-9304 | 2009-01-16 |
| 1750422655 | Regional Health Physicians Inc | Clinic/Center | 114 E Main Street, Hill City, SD 57745 | 2007-02-12 |
| 1326189754 | Regional Health Physicians Inc | Clinic/Center | 101 E. Third St., Newell, SD 57760 | 2007-02-09 |
| 1609931518 | Sioux Valley Clinic | Clinic/Center | 600 W Cedar Street (highway 46), Beresford, SD 57004 | 2006-12-22 |
| 1588677892 | Avera Mckennan | Clinic/Center | 305 N 2nd Ave, Revillo, SD 57259-0006 | 2006-08-15 |
| Find all providers with the same taxonomy | ||||
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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.