NPIMap

Organization Active NPI

Avera Queen of Peace

Doing business as Avera Therapy Mitchell

  • Physical Therapist
  • Mitchell, SD
National Provider Identifier
1922448034
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
AVERA QUEEN OF PEACE
Doing business as
Avera Therapy Mitchell
Practice address
2100 N Kimball St
Mitchell, SD 57301-1164
Phone
(605) 996-8712
NPI assigned
Jul 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Hilary Rockwell
Title
President/Ceo
Phone
(605) 668-8322

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

2100 N Kimball St
Mitchell, SD 57301-1164

Mailing address

525 N Foster St
Mitchell, SD 57301-2966

Other practice location 1

200 Paul Gust Rd Ste 109
Chamberlain, SD 57325-1021
Phone (605) 995-2000

Other practice location 2

200 E Havens Ave
Mitchell, SD 57301-3906
Phone (605) 996-8712

Other practice location 3

1900 Grassland Dr Ste 104
Mitchell, SD 57301-6386
Phone (605) 996-8712

Other practice location 4

404 E Davenport St
Plankinton, SD 57368-2082
Phone (605) 995-2000

Other names 1

  • Avera Therapy Mitchell Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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…

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

National Provider Directory

National Provider Directory

Locations

1900 Grassland Dr
Ste 104
Mitchell, SD 57301
Phone (605) 996-8712

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1922448034",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N KIMBALL ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011164",
            "telephone_number": "605-996-8712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Paul Gust Rd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Chamberlain",
            "state": "SD",
            "postal_code": "573251021",
            "country_code": "US",
            "telephone_number": "605-995-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 E HAVENS AVE",
            "address_purpose": "LOCATION",
            "city": "Mitchell",
            "state": "SD",
            "postal_code": "573013906",
            "country_code": "US",
            "telephone_number": "605-996-8712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Grassland Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Mitchell",
            "state": "SD",
            "postal_code": "573016386",
            "country_code": "US",
            "telephone_number": "605-996-8712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "404 E Davenport St",
            "address_purpose": "LOCATION",
            "city": "Plankinton",
            "state": "SD",
            "postal_code": "573682082",
            "country_code": "US",
            "telephone_number": "605-995-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVERA QUEEN OF PEACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-03",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "ROCKWELL",
        "authorized_official_first_name": "HILARY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-668-8322"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Therapy Mitchell",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Therapy Mitchell",
            "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 Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.