AVERA QUEEN OF PEACE (NPI# 1497750384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497750384 |
| Entity Type | Organization |
| Organization Name | AVERA QUEEN OF PEACE |
| Other Organization Name | AVERA BRADY ASSISTED LIVING |
| Practice Address |
1414 W Cedar Ave Mitchell SD 57301-3868 |
| Mailing Address |
525 N Foster St Mitchell SD 57301-2966 |
| Practice Telephone | 6059967702 |
| Mailing Telephone | 6059952000 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-08-20 |
| Authorized Official Name | DOUGLAS EKEREN (PRESIDENT/CEO) |
| Authorized Official Telephone | 6056688322 |
| Is Organization Subpart | Y |
| Parent Organization Name | AVERA QUEEN OF PEACE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 41972 | SD | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 9571240 | 05 |
| Other Name | Type Code |
|---|---|
| Avera Brady Assisted Living | Doing Business As Name - Organization |
| 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 |
| Street Address |
1414 W CEDAR AVE |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-3868 |
| 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 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 |
|---|---|---|---|---|
| 1760094122 | Mitchell Retirement | Assisted Living Facility | 2100 N Wisconsin St, Mitchell, SD 57301-1261 | 2020-08-18 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1518393636 | Edgewood Prairie Crossings Mitchell | Assisted Living Facility | 2201 N Wisconsin St, Mitchell, SD 57301-1074 | 2013-09-20 |
| 1073749743 | Good Samaritan-sanford Community Health Services | Assisted Living Facility | 2211 N Wisconsin St, Mitchell, SD 57301-1074 | 2009-06-08 |
| 1164613279 | Tender Hearts | Assisted Living Facility | 1510 E 1st Ave, Mitchell, SD 57301-3706 | 2007-08-05 |
| 1689712952 | City of Mitchell | Assisted Living Facility | 1723 23rd St, Mitchell, NE 69357 | 2007-02-01 |
| 1649566209 | Rosewood Court | Assisted Living Facility | 910 W Havens Ave, Mitchell, SD 57301-3831 | 2011-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588277099 | Yankton Aw | Assisted Living Facility | 2903 Douglas Ave, Yankton, SD 57078-4888 | 2020-08-25 |
| 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 |
| 1760835052 | Rclalc,llc | Assisted Living Facility | 409 E Fairlane Dr, Rapid City, SD 57701-7207 | 2016-07-21 |
| 1730554577 | Edgewood Pierre LLC | Assisted Living Facility | 1950 E 4th St, Pierre, SD 57501-4201 | 2015-12-04 |
| 1083089825 | Edgewood Prairie Crossings Watertown Il LLC | Assisted Living Facility | 901 14th Ave Ne, Watertown, SD 57201-6817 | 2015-12-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on AVERA QUEEN OF PEACE.
| 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.