AVERA ST. LUKE'S (NPI# 1871728501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871728501 |
| Entity Type | Organization |
| Organization Name | AVERA ST. LUKE'S |
| Other Organization Name | AVERA ST. LUKE'S FASTCARE SHOPKO |
| Practice Address |
500 N Highway 281 Aberdeen SD 57401-1821 |
| Mailing Address |
Po Box 1460 Aberdeen SD 57402-1460 |
| Practice Telephone | 6056222856 |
| Practice Fax Number | 6056225963 |
| Mailing Telephone | 6056222856 |
| Mailing Fax Number | 6056225963 |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2011-06-29 |
| Authorized Official Name | MR. RON L JACOBSON (PRESIDENT & CEO) |
| Authorized Official Telephone | 6056225125 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 10525 | SD | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Avera St. Luke's FastCare Shopko | 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 |
500 N HIGHWAY 281 |
| City | ABERDEEN |
| State | SD |
| Zip Code | 57401-1821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548211105 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 500 N Highway 281, Aberdeen, SD 57401-1821 | 2006-05-16 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851883540 | Modern Day Health Care Prof LLC | Family Medicine | 125 Railroad Ave Se, Aberdeen, SD 57401-4202 | 2018-05-30 |
| 1639597370 | Jason Li | Family Medicine | 17 Beacon Ln, Aberdeen, NJ 07747-2301 | 2014-03-31 |
| 1154695344 | Urgent Cares of America North Carolina Inc. | Family Medicine | 1800 N Sandhills Blvd, Aberdeen, NC 28315-2336 | 2012-03-06 |
| 1184919151 | Oluwakemi Ajide | Family Medicine | 1013 Beards Hill Rd, Suite 103, Aberdeen, MD 21001-2293 | 2011-06-17 |
| 1316237092 | Rose Mary Hatem Bonsack | Family Medicine | 205 Hemlock La., Aberdeen, MD 21001 | 2011-04-14 |
| 1013143296 | Avera St. Luke's | Family Medicine | 105 S State St Ste 113, Aberdeen, SD 57401-4502 | 2009-06-02 |
| 1205992153 | Woodie Darnell Herron | Family Medicine | 200 East Commerce Street, Aberdeen, MS 39730 | 2006-12-28 |
| 1891855847 | Hope Family Center PC | Family Medicine | 210 Magnolia Square Ct, Aberdeen, NC 28315 | 2006-12-11 |
| 1992732168 | Charles D Adams | Family Medicine | 1813 Sumner St, Aberdeen, WA 98520 | 2006-06-26 |
| 1154364636 | Kevin Curtis Hayes | Family Medicine | 504 S Chestnut St, Aberdeen, MS 39730-3337 | 2006-06-13 |
| Find all providers in ABERDEEN | ||||
Please comment or provide details below to improve the information on AVERA ST. LUKE'S.
| 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.