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AVERA ST. LUKE'S NPI 1528255775


NPI Information

NPI: 1528255775
Provider Name: AVERA ST. LUKE'S

Doing Business As: AVERA MEDICAL GROUP ORTHOPEDICS ABERDEEN

Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
815 1ST AVE SE
ABERDEEN, SD
ZIP 57401
Phone: (605) 622-2570
Get Directions

AVERA ST. LUKE'S is an orthopaedic surgery in Aberdeen, SD. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. AVERA ST. LUKE'S NPI is 1528255775. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Orthopedics Aberdeen.

The provider's business location address is:

815 1ST AVE SE
ABERDEEN, SD
ZIP 57401-602
Phone: (605) 622-2570
Fax: (605) 622-2571

The provider's authorized official is Ron L Jacobson .
The authorized official title is Ceo And President and has the following contact phone number (605) 622-5230.

The enumeration date for this NPI number is 10/2/2007 and was last updated on 6/15/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic Surgery10525SOUTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19251368OTHERSOUTH DAKOTADAKOTACARE
20588460003MEDICARE NSCSOUTH DAKOTA
3CG5835MEDICARE PINSOUTH DAKOTA
414555MEDICAIDNORTH DAKOTA
5S101808MEDICARE PINSOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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