AVERA ST. LUKE'S (NPI# 1780815506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780815506 |
| Entity Type | Organization |
| Organization Name | AVERA ST. LUKE'S |
| Other Organization Name | AVERA MEDICAL GROUP NEUROSURGERY ABERDEEN |
| Practice Address |
310 S Penn St Suite 203 Aberdeen SD 57401 |
| Mailing Address |
Po Box 1460 Aberdeen SD 57402-1460 |
| Practice Telephone | 6056222607 |
| Practice Fax Number | 6026222608 |
| Mailing Telephone | 6056222607 |
| Mailing Fax Number | 6056222608 |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2018-08-16 |
| 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 | 207T00000X | Neurological Surgery | 10525 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 10935 | 05 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Neurosurgery 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 |
| 1083051817 | Avera St. Luke's | Anesthesiology | 815 1st Ave Se, Aberdeen, SD 57401 | 2013-06-03 |
| 1912265489 | Avera St. Luke's | Internal Medicine | 310 S Penn St, Ste 203, Aberdeen, SD 57401 | 2012-05-02 |
| 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 |
310 S PENN ST SUITE 203 |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851394662 | Richard J Conklin | Internal Medicine | 310 S Penn St, Suite 105, Aberdeen, SD 57401-4553 | 2005-05-24 |
| 1407309057 | Chelsea R Westerman | Nurse Practitioner | 310 S Penn St, Suite 204, Aberdeen, SD 57401-4553 | 2016-08-01 |
| 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 |
| 1912265489 | Avera St. Luke's | Internal Medicine | 310 S Penn St, Ste 203, Aberdeen, SD 57401 | 2012-05-02 |
| 1720376825 | Christopher L Nelson | Nurse Practitioner | 310 S Penn St, Suite 105, Aberdeen, SD 57401-4553 | 2011-07-11 |
| 1669769998 | Shanna M. Anderson | Nurse Practitioner | 310 S Penn St, Suite 203, Aberdeen, SD 57401-4553 | 2011-07-07 |
| 1154641595 | Charles L. Pelton Jr. | Physician Assistant | 310 S Penn St, Suite 202, Aberdeen, SD 57401-4553 | 2010-06-08 |
| 1720317118 | Avera St. Luke's | Obstetrics & Gynecology | 310 S Penn St, Suite 204, Aberdeen, SD 57401 | 2009-12-14 |
| 1295990141 | Christopher M Larson | Surgery | 310 S Penn St, Suite 201, Aberdeen, SD 57401-4553 | 2008-07-21 |
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| 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 | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669510186 | Neurospine of Aberdeen LLC | Neurological Surgery | 310 S Penn St, #202, Aberdeen, SD 57401 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871109827 | Wilson T Asfora Md Frcsc PC | Neurological Surgery | 6709 S Minnesota Ave Ste 206a, Sioux Falls, SD 57108-2593 | 2020-09-16 |
| 1033130216 | Eric Robert Trumble | Neurological Surgery | 1210 W 18th St Ste 100, Sioux Falls, SD 57104-4650 | 2006-07-22 |
| 1417917667 | Edward L Seljeskog | Neurological Surgery | 2151 Skyline Ranch Rd, Rapid City, SD 57701-8943 | 2006-03-23 |
| 1477512036 | Larry L Teuber | Neurological Surgery | 9701 Clarkson Rd, Rapid City, SD 57702-9100 | 2006-03-22 |
| 1033188594 | Stuart Glen Rice | Neurological Surgery | 4141 5th St, Rapid City, SD 57701-6021 | 2006-03-16 |
| 1417921685 | Daniel Gerard Tynan | Neurological Surgery | 1301 S. Cliff Ave, Ste 610, Sioux Falls, SD 57105-1032 | 2006-02-15 |
| 1750355236 | Mark Warren Fox | Neurological Surgery | 1100 E 21st St, Ste 220, Sioux Falls, SD 57105-1020 | 2006-02-14 |
| 1124091293 | Jay J Schindler | Neurological Surgery | 2805 Fifth Street, Suite 100, Rapid City, SD 57701-7306 | 2006-02-09 |
| 1194706754 | Wilson T Asfora Md Frcsc PC | Neurological Surgery | 2601 S Minnesota Avenue, Ste 105 Mb385, Sioux Falls, SD 57105 | 2005-11-10 |
| 1316369523 | Nessim Amin | Neurological Surgery | 1210 W 18th St Ste 100, Sioux Falls, SD 57104-4650 | 2014-01-08 |
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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.