AVERA ST. LUKE'S (NPI# 1083051817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083051817 |
Entity Type | Organization |
Organization Name | AVERA ST. LUKE'S |
Other Organization Name | AVERA MEDICAL GROUP PAIN MANAGEMENT ABERDEEN |
Practice Address |
815 1st Ave Se Aberdeen SD 57401 |
Mailing Address |
Po Box 1460 Aberdeen SD 57402-1460 |
Practice Telephone | 6056225123 |
Practice Fax Number | 6056225906 |
Mailing Telephone | 6056222857 |
Mailing Fax Number | 6056222859 |
Enumeration Date | 2013-06-03 |
Last Update Date | 2020-04-02 |
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 | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Avera Medical Group Pain Management 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 |
1912265489 | Avera St. Luke's | Internal Medicine | 310 S Penn St, Ste 203, Aberdeen, SD 57401 | 2012-05-02 |
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 |
815 1ST AVE SE |
City | ABERDEEN |
State | SD |
Zip Code | 57401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275515736 | Marie Quaschnick | Nurse Practitioner | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2005-11-18 |
1982030177 | Avera St. Luke's | Physician Assistant | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2013-09-19 |
1386991412 | Olawunmi Aabiodun Lawal | Internal Medicine | 815 1st Ave Se, Suite 104, Aberdeen, SD 57401-4602 | 2012-08-08 |
1871869172 | Blake Anthony Heinz | Internal Medicine | 815 1st Ave Se, Suite 104, Aberdeen, SD 57401-4602 | 2012-03-30 |
1184893349 | Arlin Monroe Myrmoe | Internal Medicine | 815 1st Ave Se, Suite E104, Aberdeen, SD 57401-4602 | 2008-02-21 |
1528255775 | Avera St. Luke's | Orthopaedic Surgery | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2007-10-02 |
1770603888 | Shawna M. Schmidt | Anesthesiology | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2007-03-30 |
1588715064 | Kendall R. Goetz | Pharmacist | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2007-01-13 |
1407945918 | Lisa Beth Wurnig-johnson | Physician Assistant | 815 1st Ave Se, Aberdeen, SD 57401-4602 | 2006-10-12 |
1588752463 | Jennifer Joyce Daggett | Pharmacist | 815 1st Ave Se, #202, Aberdeen, SD 57401-4602 | 2006-10-10 |
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 | 207LP2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Anesthesiology |
Specialization | Pain Medicine |
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356410161 | Timothy J Metz | Anesthesiology | 911 E 20th St Ste 602, Sioux Falls, SD 57105-1048 | 2006-11-07 |
1205857901 | Todd Christopher Johnson | Anesthesiology | 101 Tower Rd Ste 103, Dakota Dunes, SD 57049-5007 | 2006-07-21 |
1073508131 | James T Brunz | Anesthesiology | 810 E 23rd St, Sioux Falls, SD 57105-2135 | 2005-09-14 |
1093736779 | John Edward Cook | Anesthesiology | 600 N Sioux Point Rd, Dakota Dunes, SD 57049-5000 | 2006-07-21 |
1841211471 | Frederick Charles Fisher | Anesthesiology | 600 N Sioux Point Rd, Dakota Dunes, SD 57049-5000 | 2006-07-21 |
1376588434 | Patrick L Retterath | Anesthesiology | 1512 4th St Ne, Watertown, SD 57201-6824 | 2006-06-20 |
1508806704 | Scott A Lockwood | Anesthesiology | 1301 S Cliff Ave, Sioux Falls, SD 57105-1005 | 2006-06-07 |
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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.