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AVERA QUEEN OF PEACE NPI 1053557967


NPI Information

NPI: 1053557967
Provider Name: AVERA QUEEN OF PEACE

Doing Business As: AVERA HOEK MEDICAL CLINIC

Classification: Physician Assistant - 363A00000X
Entity Type: Organization
Address:
115 SECOND ST SE
DE SMET, SD
ZIP 57231
Phone: (605) 854-3834
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AVERA QUEEN OF PEACE is a physician assistant in De Smet, 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 1053557967. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Hoek Medical Clinic.

The provider's business location address is:

115 SECOND ST SE
DE SMET, SD
ZIP 57231-463
Phone: (605) 854-3834
Fax: (605) 854-3878

The provider's authorized official is Patrick J. Clark .
The authorized official title is Senior Vice President And Cfo and has the following contact phone number (605) 995-2251.

The enumeration date for this NPI number is 12/23/2008 and was last updated on 3/1/2010.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant0232SDSOUTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1S1639MEDICARE 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: 5/5/2024

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