AVERA ST LUKES (NPI# 1457309270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457309270 |
| Entity Type | Organization |
| Organization Name | AVERA ST LUKES |
| Practice Address |
305 S State St Aberdeen SD 57401-4527 |
| Practice Telephone | 6056225000 |
| Practice Fax Number | 6056225255 |
| Mailing Telephone | 6056225000 |
| Mailing Fax Number | 6056225255 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2013-03-22 |
| Authorized Official Name | TODD ALLAN FORKEL (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6056225125 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
SD | Dietary & Nutritional Service Providers | |
| N | 3416A0800X |
Ambulance Specialization: Air Transport |
10525 | SD | Transportation Services |
| Y | 282N00000X | General Acute Care Hospital | 10525 | SD | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 01087 | 05 | |
| SD | 5590280 | 05 | |
| SD | 9020650 | 05 | |
| SD | 0100140 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932203015 | Avera St Lukes | Internal Medicine | 201 S Lloyd St Ste W240, Aberdeen, SD 57401-4530 | 2006-09-11 |
| 1174548937 | Avera St Lukes | Radiology | 1400 10th Ave W, Mobridge, SD 57601-1246 | 2006-07-13 |
| 1386693430 | Avera St Lukes | Skilled Nursing Facility | 1002 N Jay St, Aberdeen, SD 57401-2439 | 2006-05-08 |
| 1831504711 | Avera St Lukes | Clinic/Center | 310 S Penn St, Ste 201, Aberdeen, SD 57401 | 2014-06-30 |
| 1780004713 | Avera St Lukes | Radiology | 310 S Penn St, Suite 105, Aberdeen, SD 57401 | 2014-04-17 |
| 1386738102 | Avera St Lukes | Pharmacy | 305 S State St, Aberdeen, SD 57401-4527 | 2006-10-03 |
| 1912011867 | Avera St Lukes | Prosthetic/Orthotic Supplier | 305 S State St, Aberdeen, SD 57401-4527 | 2006-08-18 |
| 1760423057 | Avera St Lukes | Clinic/Center | 240 Main St, Ellendale, ND 58436 | 2006-06-09 |
| 1013968940 | Avera St Lukes | Medicare Defined Swing Bed Unit | 305 S State St, Aberdeen, SD 57401-4527 | 2006-05-15 |
| 1003867029 | Avera St Lukes | Psychiatric Hospital | 305 S State St, Aberdeen, SD 57401-4527 | 2006-05-15 |
| Street Address |
305 S STATE ST |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-4527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790789543 | Russell C Pietz | Family Medicine | 305 S State St, Aberdeen, SD 57401-4527 | 2005-06-09 |
| 1942824701 | Stacy Lynn Anderson | Pharmacist | 305 S State St, Aberdeen, SD 57401-4527 | 2020-06-07 |
| 1124502646 | Avera St Luke's | Emergency Medicine | 305 S State St, Aberdeen, SD 57401-4527 | 2018-09-20 |
| 1689150252 | Kim Susanne Kram | Specialist/Technologist | 305 S State St, Aberdeen, SD 57401-4527 | 2018-07-17 |
| 1144769522 | Gerhard Marx | Social Worker | 305 S State St, Aberdeen, SD 57401-4527 | 2017-02-17 |
| 1851771133 | Susan Gutenkauf | Occupational Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-06-02 |
| 1538548649 | Melanie C Erickson | Occupational Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-05-21 |
| 1639557184 | Carrie Ann Werth | Occupational Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-05-15 |
| 1861870404 | Buckley D Norris | Occupational Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-05-15 |
| 1285012005 | Jason Stolp | Physical Therapist | 305 S State St, Aberdeen, SD 57401-4527 | 2015-05-13 |
| 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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144676487 | Grays Harbor Community Hospital | General Acute Care Hospital | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2016-05-05 |
| 1144687559 | Rehabvisions | General Acute Care Hospital | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2016-01-15 |
| 1184977654 | Grays Harbor Community Hospital | General Acute Care Hospital | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2012-10-22 |
| 1477824183 | Sanford Health Network | General Acute Care Hospital | 2905 3rd Ave Se, Aberdeen, SD 57401-5420 | 2012-01-26 |
| 1235406455 | Sanford Health Network | General Acute Care Hospital | 2905 3rd Ave Se, Aberdeen, SD 57401-5420 | 2011-11-17 |
| 1720121650 | Grays Harbor Community Hospital | General Acute Care Hospital | 915 Anderson Drive, Aberdeen, WA 98520 | 2007-02-14 |
| 1881735462 | Grays Harbor Surgeons | General Acute Care Hospital | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2007-02-08 |
| 1659411486 | Grays Harbor House Hospitalist | General Acute Care Hospital | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2007-02-08 |
| 1063558450 | Theresa Zens Backous | General Acute Care Hospital | 305 S State St, Aberdeen, SD 57401-4527 | 2007-01-30 |
| 1356381321 | Grays Harbor Er Physicians | General Acute Care Hospital | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2006-06-07 |
| Find all providers in ABERDEEN | ||||
Please comment or provide details below to improve the information on AVERA ST LUKES.
| 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.