NPIMap

Organization Active NPI

Sacred Heart Health Services

  • Ophthalmology Physician
  • Yankton, SD
National Provider Identifier
1003585548
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SACRED HEART HEALTH SERVICES
Practice address
415 W 3Rd St
Yankton, SD 57078-4201
Phone
(605) 665-9638
Fax
(605) 665-0526
NPI assigned
Sep 8, 2021
Organization subpart
Yes
Parent organization
SACRED HEART HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Douglas W Ekeren
Title
President/Ceo
Phone
(605) 668-8322

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

415 W 3Rd St
Yankton, SD 57078-4201

Mailing address

PO Box 860674
Minneapolis, MN 55486-0605
Phone (605) 665-9638

Other practice location 1

100 N 37th St
Norfolk, NE 68701-3265
Phone (605) 665-9638

Other practice location 2

202 S Robinson Ave
Hartington, NE 68739-5501
Phone (605) 665-9638

Other practice location 3

817 Main St
Creighton, NE 68729-4003
Phone (605) 665-9638

Other practice location 4

3901 W Norfolk Ave Ste L
Norfolk, NE 68701-9218
Phone (605) 665-9638

Other names 1

  • Avera Medical Group Willcockson Eye Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040128000978 SD Part B Supplier - Clinic/Group Practice 6103729066 Receives reassigned benefits from 235 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yankton, SD; Tyndall, SD; Wagner, SD; Vermillion, SD; Scotland, SD; Parkston, SD; Mitchell, SD; Gregory, SD
O20091020000415 NE Part B Supplier - Clinic/Group Practice 6103729066 Receives reassigned benefits from 47 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Creighton, NE; Verdigre, NE; Pierce, NE; Oniell, NE; Oneill, NE; Norfolk, NE; Niobrara, NE; Hartington, NE…

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Part of
Sacred Heart Cancer Cen

Locations

202 S Robinson Ave
Hartington, NE 68739
Phone (402) 254-2020

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1003585548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860674",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860605",
            "telephone_number": "605-665-9638",
            "fax_number": "605-665-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W 3RD ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570784201",
            "telephone_number": "605-665-9638",
            "fax_number": "605-665-0526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N 37th St",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "NE",
            "postal_code": "687013265",
            "country_code": "US",
            "telephone_number": "605-665-9638",
            "fax_number": "605-665-0526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 S Robinson Ave",
            "address_purpose": "LOCATION",
            "city": "Hartington",
            "state": "NE",
            "postal_code": "687395501",
            "country_code": "US",
            "telephone_number": "605-665-9638",
            "fax_number": "605-665-0526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "817 Main St",
            "address_purpose": "LOCATION",
            "city": "Creighton",
            "state": "NE",
            "postal_code": "687294003",
            "country_code": "US",
            "telephone_number": "605-665-9638",
            "fax_number": "605-665-0526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3901 W Norfolk Ave Ste L",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "NE",
            "postal_code": "687019218",
            "country_code": "US",
            "telephone_number": "605-665-9638",
            "fax_number": "605-665-0526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SACRED HEART HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SACRED HEART HEALTH SERVICES",
        "enumeration_date": "2021-09-08",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "EKEREN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-668-8322"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Willcockson Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Medical Group Willcockson Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yankton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.