NPIMap

Organization Active NPI

Sacred Heart Health Services

Doing business as Avera Therapy Hartington

  • Physical Therapist
  • Yankton, SD
National Provider Identifier
1053838508
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SACRED HEART HEALTH SERVICES
Doing business as
Avera Therapy Hartington
Avera Therapy Yankton
Practice address
2525 Fox Run Pkwy Ste 100
Yankton, SD 57078-5371
Phone
(605) 260-0918
Fax
(605) 260-0912
NPI assigned
Aug 25, 2017
Last updated
Oct 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Authorized official

Name
Douglas Ekeren
Title
Ceo/President
Phone
(605) 668-8321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

2525 Fox Run Pkwy Ste 100
Yankton, SD 57078-5371

Mailing address

501 Summit St
Yankton, SD 57078-3855

Other practice location 1

105 N Broadway Ave
Hartington, NE 68739-4681
Phone (402) 254-9535

Other names 2

  • Avera Therapy Hartington Doing business as
  • Avera Therapy Yankton 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

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1053838508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SUMMIT ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 FOX RUN PKWY STE 100",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785371",
            "telephone_number": "605-260-0918",
            "fax_number": "605-260-0912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 N Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Hartington",
            "state": "NE",
            "postal_code": "687394681",
            "country_code": "US",
            "telephone_number": "402-254-9535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SACRED HEART HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "EKEREN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "605-668-8321"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Therapy Hartington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Therapy Yankton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Therapy Yankton",
            "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 Oct 11, 2022; 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.