NPIMap

Organization Active NPI

Sacred Heart Health Services

Doing business as Avera Rehab Physicians

  • Physical Medicine & Rehabilitation Physician
  • Yankton, SD
National Provider Identifier
1316182579
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SACRED HEART HEALTH SERVICES
Doing business as
Avera Rehab Physicians
Practice address
1000 W 4TH St
Suite 8
Yankton, SD 57078-3730
Phone
(605) 655-1201
Fax
(605) 655-1210
NPI assigned
Dec 2, 2008
Last updated
Feb 7, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
SACRED HEART HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Mrs. Pamela Rezac
Title
President/Ceo
Phone
(605) 668-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

1000 W 4TH St
Suite 8
Yankton, SD 57078-3730

Mailing address

1000 W 4TH St Ste 8
Yankton, SD 57078-3700
Phone (605) 655-1201

Other names 1

  • Avera Rehab Physicians Doing business as

Medicare participation

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

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 18

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

View all 18

National Provider Directory

National Provider Directory
Part of
Sacred Heart Hospital

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1316182579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W 4TH ST STE 8",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783700",
            "telephone_number": "605-655-1201",
            "fax_number": "605-655-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 4TH ST",
            "address_2": "SUITE 8",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783730",
            "telephone_number": "605-655-1201",
            "fax_number": "605-655-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SACRED HEART HEALTH SERVICES",
        "enumeration_date": "2008-12-02",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "REZAC",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-668-8000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Rehab Physicians",
            "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 Feb 7, 2012; 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.