NPIMap

Organization Active NPI

Avera St. Mary's

Doing business as Avera Therapy

  • Physical Therapist
  • Pierre, SD
National Provider Identifier
1972082683
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
AVERA ST. MARY'S
Doing business as
Avera Therapy
Practice address
1211 E Wells Ave
Pierre, SD 57501-3962
Phone
(605) 224-3100
NPI assigned
Aug 13, 2018
Last updated
May 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Shantel Krebs
Title
President/Ceo
Phone
(605) 351-5916

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

1211 E Wells Ave
Pierre, SD 57501-3962

Mailing address

PO Box 5045
Cbo Palm Place Provenrlmt
Sioux Falls, SD 57117-5045
Phone (650) 322-6428

Other names 1

  • Avera Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225000579 SD Part B Supplier - Clinic/Group Practice 0143134965 Receives reassigned benefits from 228 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pierre, SD

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 66

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 66

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1972082683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5045",
            "address_2": "CBO PALM PLACE PROVENRLMT",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175045",
            "telephone_number": "650-322-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 E WELLS AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013962",
            "telephone_number": "605-224-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA ST. MARY'S",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-13",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "KREBS",
        "authorized_official_first_name": "SHANTEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-351-5916"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Therapy",
            "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 May 17, 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.