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AVERA QUEEN OF PEACE NPI 1629361720


NPI Information

NPI: 1629361720
Provider Name: AVERA QUEEN OF PEACE

Doing Business As: AVERANOW

Classification: Physician Assistant - 363A00000X
Entity Type: Organization
Address:
1900 GRASSLAND DR
MITCHELL, SD
ZIP 57301
Phone: (605) 995-7000
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AVERA QUEEN OF PEACE is a physician assistant in Mitchell, SD. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. AVERA QUEEN OF PEACE NPI is 1629361720. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Averanow.

The provider's business location address is:

1900 GRASSLAND DR
MITCHELL, SD
ZIP 57301-205
Phone: (605) 995-7000

The provider's authorized official is Douglas Ekeren .
The authorized official title is President/ceo and has the following contact phone number (605) 668-8322.

The enumeration date for this NPI number is 5/23/2011 and was last updated on 8/20/2020.


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
1363L00000XNurse PractitionerNo
2363A00000XPhysician AssistantYes

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
12002248MEDICAIDSOUTH 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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.