Active NPI
Avera Queen of Peace
Doing business as Avera Queen of Peace Swing Bed Program
- Medicare Defined Swing Bed Hospital Unit
- Mitchell, SD
National Provider Identifier
1780689489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- License
- 10552
- Legal business name
- AVERA QUEEN OF PEACE
- Doing business as
- Avera Queen of Peace Swing Bed Program
- Practice address
- 525 N Foster St
Mitchell, SD 57301-2966 - Phone
- (605) 995-2000
- Fax
- (605) 995-2441
- NPI assigned
- Jun 17, 2005
- Last updated
- Aug 20, 2020
- Organization subpart
- Yes
- Parent organization
- AVERA QUEEN OF PEACE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Douglas Ekeren
- Title
- President/Ceo
- Phone
- (605) 668-8322
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 10552 | SD | Primary |
Addresses
Primary practice location
525 N Foster St
Mitchell, SD 57301-2966
Mailing address
525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-2000
Other names 1
- Avera Queen of Peace Swing Bed Program
National Provider Directory
National Provider Directory- Part of
- Donald Kougl MD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1597881600000",
"number": "1780689489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 N FOSTER ST",
"city": "MITCHELL",
"state": "SD",
"postal_code": "573012966",
"telephone_number": "605-995-2000",
"fax_number": "605-995-2441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 N FOSTER ST",
"city": "MITCHELL",
"state": "SD",
"postal_code": "573012966",
"telephone_number": "605-995-2000",
"fax_number": "605-995-2441"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVERA QUEEN OF PEACE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AVERA QUEEN OF PEACE",
"enumeration_date": "2005-06-17",
"last_updated": "2020-08-20",
"certification_date": "2020-08-20",
"status": "A",
"authorized_official_last_name": "EKEREN",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "605-668-8322"
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": "SD",
"license": "10552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Avera Queen of Peace Swing Bed Program",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Avera Queen of Peace Swing Bed Program",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mitchell, SD
- Avera Queen of Peace (Avera Advanced Physical Therapy)
- Avera Queen of Peace (Avera Medical Group Orthopedics & Sports Medicine)
- Avera Queen of Peace (Avera Medical Group Orthopedics & Sports Medicine)
- Avera Queen of Peace (Avera Grassland Pharmacy)
- Avera Queen of Peace (AMG Hospitalists Mitchell)
- Avera Queen of Peace (Avera Grassland Diagnostics)
- Avera Queen of Peace (Avera Wound Care Mitchell)
- Avera Queen of Peace (Avera Queen of Peace Home Medical Equipment)
- Avera Queen of Peace (Avera Medical Group Pediatrics Mitchell)
- Avera Queen of Peace (Avera Medical Group Internal Medicine Delaney Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.