NPIMap

Organization Active NPI

Avera at Home

Doing business as Avera@Home

  • Inpatient Hospice
  • Mitchell, SD
National Provider Identifier
1124023825
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient HospiceTaxonomy code 315D00000X
License
N/A Issued in SD
Legal business name
AVERA AT HOME
Doing business as
Avera@Home
Practice address
1115 E 5TH Ave
Mitchell, SD 57301-2917
Phone
(605) 995-2268
Fax
(605) 995-5624
NPI assigned
Jun 17, 2005
Last updated
Jun 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Authorized official

Name
Mrs. Sandra Dieleman
Title
Ceo/President
Phone
(605) 322-3984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Hospice 315D00000X N/A SD Primary

Addresses

Primary practice location

1115 E 5TH Ave
Mitchell, SD 57301-2917

Mailing address

PO Box 5045
Sioux Falls, SD 57117-5045
Phone (606) 332-1872

Other names 1

  • Avera@Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131115000913 SD Part A Provider - Hospice 8820224280 Practice locations: Mitchell, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124023825. Details of each certification follow.

Hospice certification: CCN 431507

Legal name
AVERA AT HOME
Doing business as
AVERA@HOME
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 28, 1993
Last certification
Jun 9, 2021
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Jun 24, 1987 in SD
Enrollment address
1115 E 5TH Ave
Mitchell, SD 57301-2917

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Care Compare: Hospice

Medicare Care Compare
Listed as
Avera @ HomeCCN 431507 · All quality measures
Ownership
Other
Certified
Jul 28, 1993
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Avera at Home23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nathan Brand Individual Corporate OfficerDirector of Finance Jul 16, 2017
Curtis John Hohman Individual Corporate DirectorBoard Member Jul 1, 2013
Nanci J Vanpeursem Individual Corporate OfficerBoard Member Jan 1, 2022
Chad R Thury Individual Corporate DirectorBoard Member Jan 1, 2022
Debra Ann Kolecka Individual Corporate DirectorBoard Member Jul 1, 2013
Lucille F Welbig Individual Corporate DirectorBoard Member Jan 1, 2022
Debra Ann Streier Individual Corporate DirectorBoard Member Jan 1, 2022
Sandra Diane Dieleman Individual Corporate OfficerPresident and Ceo Jul 1, 2013
Corporate DirectorPresident and Ceo Jul 1, 2013
Gerald Beninga Individual Corporate DirectorBoard Member Jan 1, 2022
Carla a Van Dyke Individual W-2 Managing EmployeeRegional Director Aug 12, 2015
Matthew Gerhardt Winkelbauer Individual Corporate DirectorBoard Member Jan 1, 2022
Douglas R Ekeren Individual Corporate DirectorBoard Member Jan 1, 2022
Doris M Derynck Individual Corporate DirectorBoard Member Jul 1, 2013
Nathel Lynn Cody Individual W-2 Managing EmployeeNurse Manager Oct 15, 2015
Avera Health Organization, Sioux Falls, SD Non-profit Operational/Managerial Control Jul 1, 2013
Karen Gallagher Individual Corporate DirectorBoard Member Jul 1, 2015

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 90

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 90

Practitioners & affiliated clinicians

Affiliated clinicians 23

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1124023825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5045",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175045",
            "telephone_number": "606-332-1872",
            "fax_number": "605-322-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E 5TH AVE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012917",
            "telephone_number": "605-995-2268",
            "fax_number": "605-995-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA AT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A",
        "authorized_official_last_name": "DIELEMAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "605-322-3984",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "SD",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera@Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera@Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.