NPIMap

Organization Active NPI

St. Michael's Hospital, Inc.

Doing business as Bon Homme Family Practice - Avon

  • Rural Health Clinic/Center
  • Avon, SD
National Provider Identifier
1558305243
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST. MICHAEL'S HOSPITAL, INC.
Doing business as
Bon Homme Family Practice - Avon
Practice address
130 N Main Street
Avon, SD 57315-0064
Phone
(605) 589-2100
Fax
(605) 589-2115
NPI assigned
Jun 15, 2006
Last updated
Mar 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Ashli Danilko
Title
Ceo
Phone
(605) 589-2152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

130 N Main Street
Avon, SD 57315-0064

Mailing address

410 W 16TH Ave
Tyndall, SD 57066-2318
Phone (605) 589-2100

Other identifiers 2

IdentifierTypeStateIssuer
5340152MedicaidSD
4996776OtherSDRHC BCBS AVON

Other names 1

  • Bon Homme Family Practice - Avon Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100729000938 SD Part A Provider - Rural Health Clinic 2668380262 Practice locations: Avon, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558305243. Details of each certification follow.

Rural health clinic certification: CCN 433418

Legal name
ST MICHAEL'S HOSPITAL, INC.
Doing business as
BON HOMME FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 2002
Last certification
Feb 7, 2024
Ownership / control type
1B
Organization structure
CorporationNon-profit
Incorporated
Jun 17, 1966 in SD
Enrollment address
130 N Main St
Avon, SD 57315-0164

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
St Michaels Hospital Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Connie Tjeerdsma Individual Corporate DirectorBoard Member Dec 2, 2020
Ashli Danilko Individual Corporate OfficerBoard Appointed Ceo Sep 12, 2020 100%
Austin Koch Individual Corporate DirectorBoard Member Dec 2, 2020
Joseph Kostal Individual Corporate DirectorBoard Member Nov 20, 2012
St Michael's Hospital, Inc. Organization, Tyndall, SD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 19, 2002 100%
Steven Johnson Individual Corporate DirectorBoard Member Nov 20, 2012
Sacred Heart Health Services Organization, Yankton, SD Management services company, Non-profit Operational/Managerial Control Mar 1, 2001
Laurie Jurrens Individual Corporate DirectorBoard Member Nov 22, 2016
Joseph T Forcelle Individual Corporate DirectorBoard Member Nov 28, 2011
Lisa Ronke Individual Corporate OfficerCfo Mar 1, 2012
W-2 Managing EmployeeCfo Mar 1, 2012

Owners & managing parties with NPI records 22

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

View all 22

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Michael's Hospital, Inc.Tyndall, SD, CCN 431327 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
St Michael's Hospital, Inc.Tyndall, SD, CCN 43Z327 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Bon Homme Family PracticeTyndall, SD, CCN 433416 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 19, 2002

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 8

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

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1558305243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W 16TH AVE",
            "city": "TYNDALL",
            "state": "SD",
            "postal_code": "570662318",
            "telephone_number": "605-589-2100",
            "fax_number": "605-589-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N MAIN STREET",
            "city": "AVON",
            "state": "SD",
            "postal_code": "573150064",
            "telephone_number": "605-589-2100",
            "fax_number": "605-589-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MICHAEL'S HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "DANILKO",
        "authorized_official_first_name": "ASHLI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-589-2152"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5340152",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC BCBS AVON",
            "identifier": "4996776",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Homme Family Practice - Avon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bon Homme Family Practice - Avon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon, SD

Sources for this page

Verify at the official NPI Registry.