Organization
AVERA QUEEN OF PEACE
Active
Organization
AVERA QUEEN OF PEACE
Active
Other names
Avera Medical Group Orthopedics & Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS EKEREN (PRESIDENT/CEO)
(605) 668-8322
Entity
Organization
Contact information
Practice address
625 N FOSTER ST, SUITE 200, MITCHELL, SD 57301-2969
(605) 996-3963
(605) 996-0718
Mailing address
625 N FOSTER ST, SUITE 200, MITCHELL, SD 57301-2969
(605) 995-2000
(605) 995-2441
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
100-1023
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100130
—
SD
Enumeration date
06/27/2007
Last updated
08/20/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up