Avera Medical Group
Organization Active NPI Physician Assistant · Pierre, SD
NPI 1003363490 · NPPES record last updated Sep 2, 2016
Key facts
- NPI
- 1003363490
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1052 (SD)
- Legal business name
- AVERA MEDICAL GROUP
- Practice address
- 100 Mac LN
Pierre, SD 57501-3391 - Phone
- (605) 224-5901
- NPI assigned
- Sep 2, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- AVERA
Authorized official
- Name
- Jenna Zellmer
- Title
- HR
- Phone
- (605) 224-5901
National Provider Directory
- Part of
- Avera Medical Group
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant |
363A00000X | 1052 | SD | Yes |
Addresses
Primary practice location
100 Mac LN
Pierre, SD 57501-3391
Mailing address
100 Mac LN
Pierre, SD 57501-3391
Phone (605) 224-5901
Other providers in Pierre, SD
- Avera at Home
- Avera at Home
- Avera Home Medical Equipment, LLC
- Avera McKennan
- Avera McKennan
- Avera St Marys
- Avera St Marys
- Avera St Marys
- Avera St Marys
- Avera St Marys
All providers in Pierre, SD · Physician Assistant in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.