NPIMap

Organization Active NPI

Avera at Home

  • Home Health Agency
  • Mitchell, SD
National Provider Identifier
1740313121
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
AVERA AT HOME
Practice address
1115 E 5TH Ave
Mitchell, SD 57301-2917
Phone
(605) 995-2268
NPI assigned
Mar 14, 2007
Organization subpart
No

National Provider Directory

National Provider Directory
Tax ID family
Avera at Home23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

1115 E 5th Ave
Mitchell, SD 57301
Phone (605) 995-2268

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Authorized official

Name
Ms. Sandra D Dieleman
Title
Ceo/President
Phone
(605) 322-3984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1115 E 5TH Ave
Mitchell, SD 57301-2917

Mailing address

PO Box 5045
Sioux Falls, SD 57117-5045
Phone (650) 322-1872

Other identifiers 1

IdentifierTypeStateIssuer
9550320MedicaidSD

Other names 1

  • Avera@Home Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1740313121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5045",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175045",
            "telephone_number": "650-322-1872",
            "fax_number": "605-322-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E 5TH AVE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012917",
            "telephone_number": "605-995-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA AT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "DIELEMAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "605-322-3984",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9550320",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera@Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera@Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.