Avera Gettysburg

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

10624 Issued in SD

Legal business name

AVERA GETTYSBURG

Doing business as

Oahe Manor

Practice address

700 E Garfield Ave
Gettysburg, SD 57442-1327

Phone

(605) 765-2488

NPI assigned

Jan 27, 2006

Last updated

Jul 15, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mikel Holland

Title

Ceo/President

Phone

(605) 224-3144

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oahe Manor Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Avera Gettysburg3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Avera Gettysburg

  dba Avera Missouri River Health Center

  • Critical Access Hospital
  • Gettysburg, SD
  • NPI 1003887266
  NPD tax ID
• Avera Gettysburg

  dba Avera Missouri River Health Center (Swingbed)

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

Practitioners 1

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.

• Chad J Carda, MD

  • Family Medicine Physician
  • Chamberlain, SD
  • NPI 1013139823
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1790756963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E GARFIELD AVE",
            "city": "GETTYSBURG",
            "state": "SD",
            "postal_code": "574421327",
            "telephone_number": "605-765-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E GARFIELD AVE",
            "city": "GETTYSBURG",
            "state": "SD",
            "postal_code": "574421327",
            "telephone_number": "605-765-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA GETTYSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "MIKEL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "605-224-3144"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "SD",
            "license": "10624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160910",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oahe Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oahe Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avera Gettysburg (Avera Missouri River Health Center)
• Avera Gettysburg (Avera Medical Group Gettysburg)
• Avera Gettysburg (Avera Missouri River Health Center (Swingbed))
• Jenny Renee Beetsch
• Connie Belford, C.N.P.
• Ethan David Burdman, PA-C, MPAS
• City of Gettysburg

• Nursing Facility/Intermediate Care Facility in Gettysburg, SD
• Providers in Gettysburg, SD by specialty
• Nursing Facility/Intermediate Care Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.