NPIMap

Organization Active NPI

City of Brookings

Doing business as Avera Medical Group a Department of Brookings Health System

  • Multi-Specialty Clinic/Center
  • Brookings, SD
National Provider Identifier
1134558158
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CITY OF BROOKINGS
Doing business as
Avera Medical Group a Department of Brookings Health System
Practice address
400 22ND Ave
Brookings, SD 57006-2450
Phone
(605) 697-9500
Fax
(605) 697-6939
NPI assigned
Nov 12, 2013
Last updated
Apr 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Mrs. Melissa Wagner
Title
Cfo
Phone
(605) 696-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

400 22ND Ave
Brookings, SD 57006-2450

Mailing address

300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 696-9000

Other names 1

  • Avera Medical Group a Department of Brookings Health System Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040423000002 SD Part B Supplier - Clinic/Group Practice 1052307105 Receives reassigned benefits from 171 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White, SD; Volga, SD; Madison, SD; Flandreau, SD; Dell Rapids, SD; De Smet, SD; Brookings, SD; Arlington, SD
O20101029001272 SD Part A Provider - Hospital 1052307105 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brookings, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134558158. Details of each certification follow.

Hospital certification: CCN 430008

Legal name
CITY OF BROOKINGS
Doing business as
BROOKINGS HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 6, 2025
Beds
49
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
300 22ND Ave
Brookings, SD 57006-2474
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 6

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Brookings Health SystemCCN 430008 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

302 E 5th St
White, SD 57276
Phone (605) 629-3333

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
City of Brookings Organization, Brookings, SD 5% Or Greater Direct Ownership Interest Jun 8, 2010
Jason R Merkley Individual Corporate OfficerCeo Dec 5, 2011
Melissa Wagner Individual Corporate OfficerCfo Sep 15, 2018
W-2 Managing Employee Sep 15, 2018

Owners & managing parties with NPI records 9

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

  • City of Brookings

    dba Brookings Health System

    • General Acute Care Hospital
    • Brookings, SD
    • NPI 1275515579

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Community Based Hospice Care Agency
    • Brookings, SD
    • NPI 1306928494

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Skilled Nursing Facility
    • Brookings, SD
    • NPI 1417039504

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings
    • Rural Health Clinic/Center
    • Volga, SD
    • NPI 1811318074

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Home Health Agency
    • Brookings, SD
    • NPI 1861574956

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System Arlington Medical Center

    • Rural Health Clinic/Center
    • Arlington, SD
    • NPI 1902123581

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System White Clinic

    • Rural Health Clinic/Center
    • White, SD
    • NPI 1912279829

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Anesthesiology Physician
    • Brookings, SD
    • NPI 1932281029

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Medicare Defined Swing Bed Hospital Unit
    • Brookings, SD
    • NPI 1962584052

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 146

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 146

Affiliated clinicians 209

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

View all 209

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1134558158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062480",
            "telephone_number": "605-696-9000",
            "fax_number": "605-696-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062450",
            "telephone_number": "605-697-9500",
            "fax_number": "605-697-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BROOKINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-696-9000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group a Department of Brookings Health System",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Medical Group a Department of Brookings Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookings, SD

Sources for this page

Verify at the official NPI Registry.