AVERA ST LUKE'S (NPI# 1124163225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124163225 |
| Entity Type | Organization |
| Organization Name | AVERA ST LUKE'S |
| Other Organization Name | AVERA NANO NAGLE VILLAGE |
| Practice Address |
1020 N Jay St Aberdeen SD 57401-2480 |
| Practice Telephone | 6056225847 |
| Practice Fax Number | 6056225255 |
| Mailing Telephone | 6056225847 |
| Mailing Fax Number | 6056225255 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RONALD L JACOBSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6056225125 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 41969 | SD | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 9572350 | 05 |
| Other Name | Type Code |
|---|---|
| Avera Nano Nagle Village | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306031976 | Avera St Luke's | Family Medicine | 8 E Us Highway 12, Groton, SD 57445-2176 | 2007-09-07 |
| 1124502646 | Avera St Luke's | Emergency Medicine | 305 S State St, Aberdeen, SD 57401-4527 | 2018-09-20 |
| 1619355633 | Avera St Luke's | Speech-Language Pathologist | 805 1st Ave Se, Aberdeen, SD 57401 | 2015-05-11 |
| 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 |
1020 N JAY ST |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-2480 |
| 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 | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447570049 | Monarch | Assisted Living Facility | 617 El Ives Dr, Aberdeen, NC 28315-3618 | 2010-06-04 |
| 1962643411 | Community Alternative Housing | Assisted Living Facility | 101 Michael Ln, Aberdeen, NC 28315-2223 | 2009-03-12 |
| 1457481988 | Peterkin & Associates, Inc. | Assisted Living Facility | 1112 Devonshire Trl, Aberdeen, NC 28315-3910 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588277099 | Yankton Aw | Assisted Living Facility | 2903 Douglas Ave, Yankton, SD 57078-4888 | 2020-08-25 |
| 1760094122 | Mitchell Retirement | Assisted Living Facility | 2100 N Wisconsin St, Mitchell, SD 57301-1261 | 2020-08-18 |
| 1346897352 | Huron Sd Assisted Living Facility LLC | Assisted Living Facility | 1251 Arizona Ave Sw, Huron, SD 57350-3015 | 2019-08-23 |
| 1972076024 | Edgewood Rapid City LLC | Assisted Living Facility | 4001 Derby Lane, Rapid City, SD 57701 | 2019-01-10 |
| 1447722210 | Sturgis Assisted Living, LLC | Assisted Living Facility | 2065 Moose Dr, Sturgis, SD 57785-4003 | 2018-12-18 |
| 1326516501 | Edgewood Watertown Mc 2 LLC | Assisted Living Facility | 225 14 Ave Ne, Watertown, SD 57201 | 2018-11-06 |
| 1306336656 | Will Care Services, LLC | Assisted Living Facility | 4709 E 6th St, Sioux Falls, SD 57110-5851 | 2018-05-12 |
| 1538656400 | Viborg Retirement Living, Inc | Assisted Living Facility | 211 Peterson Drive, Viborg, SD 57070 | 2018-04-17 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1760835052 | Rclalc,llc | Assisted Living Facility | 409 E Fairlane Dr, Rapid City, SD 57701-7207 | 2016-07-21 |
| 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.