AVERA QUEEN OF PEACE


Address: 605 N Foster St, Mitchell, SD 57301-2902
Phone: (605) 995-5756

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
SD MEDICARE S1639 01

Other Provider/Organization Names

Other Name Type Code
AVERA MEDICAL GROUP RADIATION ONCOLOGY MITCHELL Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 605 N FOSTER ST
City MITCHELL
State SD
Zip Code 57301-2902

Providers in the same location

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

Providers in the same zip code

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 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
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

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
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

Competitor

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City MITCHELL
Zip Code 57301

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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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