NPIMap

Organization Active NPI

Avera St Luke's

Doing business as Avera Groton Clinic

  • Family Medicine Physician
  • Groton, SD
National Provider Identifier
1306031976
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10525 Issued in SD
Legal business name
AVERA ST LUKE'S
Doing business as
Avera Groton Clinic
Avera Medical Group Groton
Practice address
8 E US Highway 12
Groton, SD 57445-2176
Phone
(605) 397-4242
Fax
(605) 397-4243
NPI assigned
Sep 7, 2007
Last updated
Apr 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Daniel J Bjerknes
Title
President/Ceo
Phone
(605) 622-5125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 10525 SD Primary

Addresses

Primary practice location

8 E US Highway 12
Groton, SD 57445-2176

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-4933

Other names 2

  • Avera Groton Clinic Doing business as
  • Avera Medical Group Groton Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000912 SD Part B Supplier - Clinic/Group Practice 6406764927 Receives reassigned benefits from 271 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, SD; Waubay, SD; Redfield, SD; Mobridge, SD; Groton, SD; Faulkton, SD; Britton, SD

Other NPIs on the same Medicare enrollment 39

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

View all 39

National Provider Directory

National Provider Directory

Locations

8 E US Highway 12
Groton, SD 57445
Phone (605) 397-4242

501 Bloemendaal Dr
Ipswich, SD 57451

1311 10th Ave W
Mobridge, SD
Phone (605) 845-3122

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1306031976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86370",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186370",
            "telephone_number": "605-322-4933",
            "fax_number": "605-504-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 E US HIGHWAY 12",
            "city": "GROTON",
            "state": "SD",
            "postal_code": "574452176",
            "telephone_number": "605-397-4242",
            "fax_number": "605-397-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA ST LUKE'S",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "BJERKNES",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-622-5125"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "10525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Groton Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Medical Group Groton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Groton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.