AVERA QUEEN OF PEACE (NPI# 1962927269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962927269 |
| Entity Type | Organization |
| Organization Name | AVERA QUEEN OF PEACE |
| Other Organization Name | AVERA MEDICAL GROUP RADIATION ONCOLOGY MITCHELL |
| Practice Address |
605 N Foster St Mitchell SD 57301-2902 |
| Mailing Address |
Po Box 432 Mitchell SD 57301-0432 |
| Practice Telephone | (605) 995-5756 |
| Practice Fax Number | 6059955750 |
| Mailing Telephone | 6059956337 |
| Mailing Fax Number | 6059955779 |
| Enumeration Date | 2017-08-08 |
| 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 | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | MEDICARE | S1639 | 01 |
| Other Name | Type Code |
|---|---|
| AVERA MEDICAL GROUP RADIATION ONCOLOGY MITCHELL | 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 |
| 1639174568 | Avera Queen of Peace | Clinic/Center | 741 S Hill St, Salem, SD 57058-8761 | 2005-06-16 |
| Street Address |
605 N FOSTER ST |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-2902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568427144 | Stephen Dick | Radiology | 605 N Foster St, Mitchell, SD 57301-2902 | 2006-04-18 |
| 1528209434 | Anwarul Haq, Md, PC | Clinic/Center | 605 N Foster St, Mitchell, SD 57301-2902 | 2009-03-23 |
| 1235327511 | Jack T. Berry | Specialist | 605 N Foster St, Mitchell, SD 57301-2902 | 2007-10-11 |
| 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 | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346339777 | Michael E Peterson Md PC | Radiology | 605 N Foster, Mitchell, SD 57301-2902 | 2006-10-12 |
| 1568427144 | Stephen Dick | Radiology | 605 N Foster St, Mitchell, SD 57301-2902 | 2006-04-18 |
| 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 |
| 1336238757 | Michael E Peterson | Radiology | 1115 W 9th St, Yankton, SD 57078-3310 | 2006-10-12 |
| 1457347007 | Daniel Martin Tackett | Radiology | 3751 Skyline Dr, Rapid City, SD 57701-5363 | 2005-09-20 |
| 1780004713 | Avera St Lukes | Radiology | 310 S Penn St, Suite 105, Aberdeen, SD 57401 | 2014-04-17 |
| 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 |
| 1578794715 | Troy Edward Adolfson | Radiology | 620 3rd Ave Se, Aberdeen, SD 57401-4554 | 2009-08-06 |
| 1265691133 | Ryan K Nowak | Radiology | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2008-06-05 |
| 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.