Avera Queen of Peace
Organization Active NPI General Practice Physician · De Smet, SD
NPI 1881964484 · NPPES record last updated Jan 22, 2026
Key facts
- NPI
- 1881964484
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- AVERA QUEEN OF PEACE
- Practice address
- 801 3Rd St SW
De Smet, SD 57231-2224 - Phone
- (605) 854-3834
- Fax
- (605) 854-3878
- NPI assigned
- Jan 12, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- AVERA HEALTH
Authorized official
- Name
- Hilary R. Rockwell
- Title
- Regional President/Ceo
- Phone
- (605) 995-2200
Other NPIs on the same Medicare enrollment 31
Corporate family (same tax ID) 28
Practitioners 12
-
Sara Jo Cashman, CNP
-
Michael Gerlach, MD
-
Dawn Marie Hill, MD
-
Bassel Jabbour, M.D
-
Daryl C Rife, MD
-
Kelly Don Smith, MD
-
Katrina Almeida, D.P.M.
-
Eric John Malsam, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 43D0931017 | Avera Medical Group de Smet | Provider-performed microscopy | Jul 20, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031229000301 | SD | Part B Supplier - Clinic/Group Practice | 9335050806 |
Receives reassigned benefits from 252 practitioners 31 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mitchell, SD; Parkston, SD; Pierre, SD; Platte, SD; Sioux Falls, SD; Wagner, SD; Wessington Springs, SD; Yankton, SD… |
National Provider Directory
- Tax ID family
- ER Phy
Locations
625 N Foster St
Mitchell, SD 57301
Phone (605) 995-6350
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes | ||
| Physician Assistant |
363A00000X |
Addresses
Primary practice location
801 3Rd St SW
De Smet, SD 57231-2224
Mailing address
PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-4933
Other names
- Avera De Smet Clinic
- Avera Medical Group De Smet
Other providers in De Smet, SD
- Bonita Marie Albrecht
- Alese M Allerdings
- Avera Queen of Peace
- Avera Queen of Peace
- Avera Queen of Peace
- Berg Medical Clinic PC
- De Smet Emergency Rescue Unit Inc.
- De Smet School District
- Kelsey Determan
- David J Dobson
All providers in De Smet, SD · General Practice Physician in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.