Avera at Home
Organization Active NPI Inpatient Hospice · Mitchell, SD
NPI 1124023825 · NPPES record last updated Jun 24, 2026
Key facts
- NPI
- 1124023825
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Inpatient Hospice 315D00000X
- License
- N/A (SD)
- Legal business name
- AVERA AT HOME
- Practice address
- 1115 E 5TH Ave
Mitchell, SD 57301-2917 - Phone
- (605) 995-2268
- Fax
- (605) 995-5624
- NPI assigned
- Jun 17, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Sandra Dieleman
- Title
- Ceo/President
- Phone
- (605) 322-3984
Owners & managing parties with NPI records 4
-
Debra Ann Kolecka, CNP
-
Chad R Thury, DO
Other NPIs with the same Medicare PAC ID 14
Corporate family (same tax ID) 22
Facilities with the same owner 90
Affiliated clinicians 23
-
Alese M Allerdings, M.D.
-
Aaron Paul Baas, MD
-
Paul David Berndt, M.D.
-
Kassidy Boyd, M.D.
-
Michael Gerlach, MD
-
Derek Greene, MD
-
Shakil I Hafiz, D.O.
-
Douglas Holum, MD
-
Lance S Lim, MD
-
Ben Liscano, MD
-
Paul Rasmussen, MD
-
Nathan J Timmer, MD
-
Hau Van Tran, DO
-
Antoinette J Vander Pol, M.D.
-
Jason W. Wickersham, M.D.
Medicare Care Compare: Hospice
- Listed as
- Avera @ Home
- Ownership
- Other
- Certified
- Jul 28, 1993
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
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
- Corporation · Non-profit
- Incorporated
- Jun 24, 1987 in SD
- Enrollment address
- 1115 E 5TH Ave
Mitchell, SD 57301-2917
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Nathan Brand |
Corporate Officer |
Jul 16, 2017 | |
| Curtis John Hohman |
Corporate Director |
Jul 1, 2013 | |
| Nanci J Vanpeursem |
Corporate Officer |
Jan 1, 2022 | |
| Chad R Thury |
Corporate Director |
Jan 1, 2022 | |
| Debra Ann Kolecka |
Corporate Director |
Jul 1, 2013 | |
| Lucille F Welbig |
Corporate Director |
Jan 1, 2022 | |
| Debra Ann Streier |
Corporate Director |
Jan 1, 2022 | |
| Sandra Diane Dieleman |
Corporate Officer |
Jul 1, 2013 | |
| Corporate Director |
Jul 1, 2013 | ||
| Gerald Beninga |
Corporate Director |
Jan 1, 2022 | |
| Carla a Van Dyke |
W-2 Managing Employee |
Aug 12, 2015 | |
| Matthew Gerhardt Winkelbauer |
Corporate Director |
Jan 1, 2022 | |
| Douglas R Ekeren |
Corporate Director |
Jan 1, 2022 | |
| Doris M Derynck |
Corporate Director |
Jul 1, 2013 | |
| Nathel Lynn Cody |
W-2 Managing Employee |
Oct 15, 2015 | |
| Avera Health |
Operational/Managerial Control | Jul 1, 2013 | |
| Karen Gallagher |
Corporate Director |
Jul 1, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131115000913 | SD | Part a Provider - Hospice | 8820224280 | Practice locations: Mitchell, SD |
National Provider Directory
- Tax ID family
- Avera at Home
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Inpatient Hospice | 315D00000X | N/A | SD | Yes |
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
- Avera@Home
Other providers in Mitchell, SD
- Andrea Walcott, LLC
- Anwarul Haq, MD, PC
- Christine Strebeck Arnold
- Whitney Asher
- Laura Assmus
- Avera at Home
- Avera at Home
- Avera Home Medical Equipment, LLC
- Avera Home Medical Equipment, LLC
- Avera McKennan
All providers in Mitchell, SD · Inpatient Hospice 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 Jun 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.