NPIMap

Organization Active NPI

Avera St Marys

Doing business as Avera Pierre Clinic

  • Multi-Specialty Clinic/Center
  • Pierre, SD
National Provider Identifier
1720326713
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
AVERA ST MARYS
Doing business as
Avera Pierre Clinic
Practice address
801 E Sioux Ave
Pierre, SD 57501-3323
Phone
(605) 224-5901
Fax
(605) 945-3244
NPI assigned
Jan 25, 2013
Last updated
Jul 1, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AVERA ST MARYSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Shantel Krebs
Title
Ceo
Phone
(605) 224-3144

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

801 E Sioux Ave
Pierre, SD 57501-3323

Mailing address

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

Other names 1

  • Avera Pierre Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040225000579 SD Part B Supplier - Clinic/Group Practice 0143134965 Receives reassigned benefits from 228 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pierre, SD
O20100726000341 SD Part A Provider - Hospital 0143134965 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pierre, SD
O20200129001386 MN Part B Supplier - Clinic/Group Practice 0143134965 Receives reassigned benefits from 4 practitioners
Practice locations: Eden Prairie, MN; Saint Paul, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720326713. Details of each certification follow.

Hospital certification: CCN 430015

Legal name
AVERA ST MARYS
Doing business as
AVERA ST MARYS HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 5, 2014
Beds
60
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 10, 1951 in SD
Enrollment address
801E Sioux Ave
Pierre, SD 57501-3323
Other Hospital Practice Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 5

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

  • Avera St Marys

    dba Avera Maryhouse Long Term Care

    • Skilled Nursing Facility
    • Pierre, SD
    • NPI 1063654648

    0143134965

    Same PAC ID
  • Avera St Marys

    dba Avera St Marys Hospital - ESRD

    • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
    • Pierre, SD
    • NPI 1144238619

    0143134965

    Same PAC ID
  • Avera St Marys

    dba Avera St. Mary's Hospital

    • General Acute Care Hospital
    • Pierre, SD
    • NPI 1669457180

    0143134965

    Same PAC ID
  • Avera St Marys

    dba Avera St. Mary's Hospital Swingbed

    • Medicare Defined Swing Bed Hospital Unit
    • Pierre, SD
    • NPI 1992713457

    0143134965

    Same PAC ID
  • Avera St. Mary's

    dba Avera St. Mary's Campus Pharmacy

    • Community/Retail Pharmacy
    • Pierre, SD
    • NPI 1932651122

    0143134965

    Same PAC ID

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Avera St Mary's HospitalCCN 430015 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Avera St Marys

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Robert Wylie Individual Corporate DirectorBoard Member Jul 1, 2021
Jeffrey Paul Hallem Individual Corporate DirectorBoard Member Jul 1, 2025
Amy Kathryn Lueking Individual Corporate DirectorBoard Member Jul 1, 2021
Debra Ann Kolecka Individual Corporate DirectorBoard Member Jul 1, 2025
Rena J Robbennolt Individual Corporate DirectorBoard Member Jul 1, 2025
Meredith Lee Individual Corporate DirectorBoard Member Jul 1, 2022
Julie Lautt Individual Corporate OfficerCfo Mar 1, 2020
Jami Kay Cronin Individual Corporate DirectorBoard Member Jul 1, 2025
Shantel Shamiele Krebs Individual Corporate OfficerPresident/Ceo Mar 13, 2023
Operational/Managerial Control Mar 13, 2023
Mark L Hagy Individual Corporate DirectorBoard Member Jul 1, 2022
Avera Health Organization, Sioux Falls, SD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2013 100%
Operational/Managerial Control Jan 1, 2013
Kristin Brost Individual Corporate DirectorBoard Member Jul 1, 2021

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Avera Missouri River Health CenterGettysburg, SD, CCN 431302 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2013
Avera Missouri River Health CenterGettysburg, SD, CCN 43Z302 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2013

Owned or controlled facilities with NPI records 2

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

  • Avera Gettysburg

    dba Avera Missouri River Health Center

    • Critical Access Hospital
    • Gettysburg, SD
    • NPI 1003887266

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Avera Gettysburg

    dba Avera Missouri River Health Center (Swingbed)

    • Medicare Defined Swing Bed Hospital Unit
    • Gettysburg, SD
    • NPI 1881754497

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 96

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 96

Affiliated clinicians 215

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

View all 215

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1720326713",
    "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": "801 E SIOUX AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013323",
            "telephone_number": "605-224-5901",
            "fax_number": "605-945-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA ST MARYS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVERA ST MARYS",
        "enumeration_date": "2013-01-25",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "KREBS",
        "authorized_official_first_name": "SHANTEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-224-3144"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Pierre Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pierre, SD

Sources for this page

Verify at the official NPI Registry.