NPIMap

Organization Active NPI

Avera St Marys

Doing business as Avera Medical Group Pierre - a dept of Avera St Marys Hospital

  • Multi-Specialty Clinic/Center
  • Pierre, SD
National Provider Identifier
1841505807
Registry record updated Jul 15, 2022
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 Medical Group Pierre - a dept of Avera St Marys Hospital
Practice address
100 Mac LN
Pierre, SD 57501-3391
Phone
(605) 224-5901
Fax
(605) 945-3177
NPI assigned
Aug 16, 2010
Last updated
Jul 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X SD Primary
General Acute Care Hospital 282N00000X 10556 SD

Addresses

Primary practice location

100 Mac LN
Pierre, SD 57501-3391

Mailing address

100 Mac LN
Pierre, SD 57501-3391
Phone (605) 224-5901

Other names 1

  • Avera Medical Group Pierre - a dept of Avera St Marys Hospital Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Avera St Marys Campus Pharmacy100 Mac LN, Pierre, SD 57501-3393(605) 224-7334 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Jan 1, 2011

National Provider Directory

National Provider Directory
Tax ID family
Jon Vandermaten PA C11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1841505807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAC LN",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013391",
            "telephone_number": "605-224-5901",
            "fax_number": "605-945-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAC LN",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013391",
            "telephone_number": "605-224-5901",
            "fax_number": "605-945-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA ST MARYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-16",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "SD",
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "SD",
            "license": "10556",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Pierre - a dept of Avera St Marys Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Medical Group Pierre - a dept of Avera St Marys Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pierre, SD

Sources for this page

  • 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.