AVERA ST. LUKES (NPI# 1477594430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477594430 |
| Entity Type | Organization |
| Organization Name | AVERA ST. LUKES |
| Other Organization Name | AVERA MEDICAL GROUP NEPHROLOGY ABERDEEN |
| Practice Address |
310 S Penn St Ste 203 Aberdeen SD 57401-4553 |
| Mailing Address |
Po Box 1460 Aberdeen SD 57402-1460 |
| Practice Telephone | 6056222895 |
| Practice Fax Number | 6056222896 |
| Mailing Telephone | 6056222857 |
| Mailing Fax Number | 6056222859 |
| Enumeration Date | 2006-06-09 |
| 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 | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 13460 | 05 | |
| SD | DAKOTACARE GROUP | 9224778 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Nephrology Aberdeen | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144206020 | Avera St. Lukes | Skilled Nursing Facility | 202 J Ave., Eureka, SD 57437-2225 | 2005-12-21 |
| 1699133579 | Avera St. Lukes | Clinic/Center | 1206 S Main St, Aberdeen, SD 57401-7071 | 2016-02-05 |
| 1003195926 | Avera St. Lukes | Pathology | 305 S State St, Aberdeen, SD 57401-4527 | 2011-08-09 |
| Street Address |
310 S PENN ST STE 203 |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-4553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205090206 | Avera St. Luke's | Clinic/Center | 310 S Penn St Ste 203, Aberdeen, SD 57401-4553 | 2008-07-18 |
| 1871771279 | Avera St. Luke's | Podiatrist | 310 S Penn St Ste 203, Aberdeen, SD 57401-4553 | 2008-02-07 |
| 1952438996 | Chad Edward Stapp | Podiatrist | 310 S Penn St Ste 203, Aberdeen, SD 57401-4553 | 2007-02-27 |
| 1295822104 | Eric Samuel Leichter | Urology | 310 S Penn St Ste 203, Aberdeen, SD 57401-4553 | 2006-10-10 |
| 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 | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902986987 | Shahid Sattar Chaudhary | Internal Medicine | 310 S Penn St, Suite 202, Aberdeen, SD 57401-4553 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083671408 | Richard A Jensen | Internal Medicine | 2333 W 57th St Ste 101, Sioux Falls, SD 57108-5054 | 2006-04-28 |
| 1851358600 | Oleg P Georgiev | Internal Medicine | 6709 S. Minnesota Avenue, Suite 101, Sioux Falls, SD 57108-2593 | 2006-04-26 |
| 1962478651 | Robert Nicholas Santella | Internal Medicine | 1315 S Cliff Ave, Ste 2000, Sioux Falls, SD 57105-1058 | 2006-02-23 |
| 1780662437 | Erin L Greer | Internal Medicine | 1315 S Cliff Ave Ste 2000, Sioux Falls, SD 57105-1058 | 2006-01-04 |
| 1417365305 | Faizan Syed | Internal Medicine | 1315 S Cliff Ave Ste 2000, Sioux Falls, SD 57105-1058 | 2014-07-24 |
| 1528348406 | Avera Queen of Peace | Internal Medicine | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2011-08-23 |
| 1265680466 | Julie Ann Tan Linatoc | Internal Medicine | 1315 S Cliff Ave, Ste. 2000, Sioux Falls, SD 57105-1058 | 2008-09-03 |
| 1689864449 | Sujan Pathak | Internal Medicine | 640 Flormann St, Rapid City, SD 57701-4679 | 2007-07-27 |
| 1336339357 | Dana Brandys | Internal Medicine | 1205 S. Grange Ave, Ste 201, Sioux Falls, SD 57105-0414 | 2007-07-26 |
| 1629278759 | Lu Y Huber | Internal Medicine | 1315 S Cliff Ave, Ste. 2000, Sioux Falls, SD 57105-1058 | 2007-07-18 |
| 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.