NPIMap

Organization Active NPI

Avera Queen of Peace

Doing business as Avera Weskota Mem Med CNTR

  • Institutional Pharmacy
  • Wessington Springs, SD
National Provider Identifier
1992712921
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
2000994 Issued in SD
Legal business name
AVERA QUEEN OF PEACE
Doing business as
Avera Weskota Mem Med CNTR
Practice address
609 1St St NE
Wessington Springs, SD 57382-2136
Phone
(605) 539-1201
NPI assigned
Aug 2, 2006
Last updated
Sep 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Authorized official

Name
Douglas Ekeren
Title
President/Ceo
Phone
(605) 668-8321

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Institutional Pharmacy 3336I0012X 2000994 SD Primary

Addresses

Primary practice location

609 1St St NE
Wessington Springs, SD 57382-2136

Mailing address

609 1St St NE
Wessington Springs, SD 57382-2136
Phone (605) 539-1201

Other identifiers 1

IdentifierTypeStateIssuer
4353859OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • AVERA WESKOTA MEM MED CNTR Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avera Queen of Peace Ho29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1992712921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 1ST ST NE",
            "city": "WESSINGTON SPRINGS",
            "state": "SD",
            "postal_code": "573822136",
            "telephone_number": "605-539-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 1ST ST NE",
            "city": "WESSINGTON SPRINGS",
            "state": "SD",
            "postal_code": "573822136",
            "telephone_number": "605-539-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA QUEEN OF PEACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "EKEREN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-668-8321"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "SD",
            "license": "2000994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4353859",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVERA WESKOTA MEM MED CNTR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AVERA WESKOTA MEM MED CNTR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wessington Springs, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.