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AVERA MEDICAL GROUP OCCUPATIONAL MEDICINE
NPI 1053548982
Specialist in Mitchell, SD

Active since June 18, 2009
525 N FOSTER ST, MITCHELL, SD 57301(605) 995-2000(605) 995-2441 Get Directions Write a Review

NPPES record last updated: August 20, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Avera Medical Group Occupational Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVERA MEDICAL GROUP OCCUPATIONAL MEDICINE (NPI 1053548982) is a healthcare organization registered as a specialist in Mitchell, South Dakota and active in the NPI registry since June 2009. The organization lists Douglas Ekeren, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1053548982
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameAVERA QUEEN OF PEACE
Location Address525 N FOSTER STMitchell, SD 57301-2966
Mailing Address525 N Foster StMitchell, SD 57301-2966 · (605) 995-2000 · Fax (605) 995-2441
Phone(605) 995-2000
Fax(605) 995-2441
Organization SubpartNo
Authorized OfficialDouglas EkerenPresident/ceo · (605) 668-8322
Enumeration DateJune 18, 2009
Last NPPES UpdateAugust 20, 2020
NPPES CertifiedAugust 20, 2020
✔ NPI 1053548982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
525 N FOSTER ST, Mitchell, SD 57301
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Other Names 1

Doing Business AsAvera Medical Group Occupational Medicine

Other Identifiers 1

Medicaid5500130SD

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Avera Medical Group Occupational Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

227

Medicare enrollment records show 227 clinicians reassign Medicare billing to Avera Medical Group Occupational Medicine, which bills Medicare for the services they deliver. Of these, 24 practice at this address and 71 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 28

Nurse Practitioner38
Diagnostic Radiology35
Internal Medicine28
Physical Therapist in Private Practice20
Certified Registered Nurse Anesthetist (CRNA)17
Family Practice12
Emergency Medicine9
Occupational Therapist in Private Practice9
20 other specialties59

Nearest to this location (20)

See all 227
Erika Clark, OTD, OTR/L
Occupational Therapist in Private Practice
NPI 1962139063
525 N FOSTER ST
Mitchell, SD 57301
(605) 955-2000
✔ Accepts MedicareSame address
Rachel Dykstra, CNP
Nurse Practitioner
NPI 1609358035
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2510
✔ PECOS✔ Accepts MedicareSame address
Phillip Becker, MD
Anesthesiology
NPI 1427092634
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ PECOS✔ Accepts MedicareSame address
Stephanie Flippin
Occupational Therapist in Private Practice
NPI 1750721296
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ Accepts MedicareSame address
Heidi Gehrke
Nurse Practitioner
NPI 1083991012
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ PECOS✔ Accepts MedicareSame address
Michael Haley, MD
Anesthesiology
NPI 1801819461
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ PECOS✔ Accepts MedicareSame address
Julie Hegg
Certified Registered Nurse Anesthetist (CRNA)
NPI 1740260579
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ Accepts MedicareSame address
Jonathan Kludt
Physical Therapist in Private Practice
NPI 1518307271
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ Accepts MedicareSame address
Cheri Knight
Physical Therapist in Private Practice
NPI 1245670819
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
Same address
Craig Magee
Physical Therapist in Private Practice
NPI 1144660804
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ Accepts MedicareSame address
James Nielsen, M.D.
Emergency Medicine
NPI 1205806460
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ PECOSSame address
Penny Petersen
Nurse Practitioner
NPI 1114907979
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ PECOSSame address
Sheryl Roesler
Certified Registered Nurse Anesthetist (CRNA)
NPI 1255311098
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ Accepts MedicareSame address
Kim Rubendall
Certified Registered Nurse Anesthetist (CRNA)
NPI 1750361598
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ Accepts MedicareSame address
William Graham, D.O.
Otolaryngology
NPI 1558450254
625 N FOSTER ST SUITE 203
Mitchell, SD 57301
(605) 996-8386
✔ PECOS✔ Accepts MedicareSame address
Brian Kampmann, MD
Orthopedic Surgery
NPI 1801014956
625 N FOSTER ST SUITE 200
Mitchell, SD 57301
(605) 996-3963
✔ PECOS✔ Accepts MedicareSame address
Chris Krouse, DO
Orthopedic Surgery
NPI 1508870619
625 N FOSTER ST SUITE 107
Mitchell, SD 57301
(605) 996-3963
✔ PECOS✔ Accepts MedicareSame address
Michael Krause, D.O.
Obstetrics/Gynecology
NPI 1073626115
625 N FOSTER ST STE 108
Mitchell, SD 57301
(605) 990-1995
✔ PECOS✔ Accepts MedicareSame address
Ahna Buntrock, MD
Obstetrics/Gynecology
NPI 1073182069
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-2000
✔ PECOS✔ Accepts MedicareSame address
Christopher Haiar
Qualified Speech Language Pathologist
NPI 1902733629
525 N FOSTER ST
Mitchell, SD 57301
(605) 995-6373
Same address
See all 227 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avera Queen Of Peace's NPI number?

The NPI number for Avera Queen Of Peace is 1053548982. It was assigned to this organization in the NPPES registry on June 18, 2009. The provider is doing business as Avera Medical Group Occupational Medicine.

Where is Avera Queen Of Peace located?

Avera Queen Of Peace is located at 525 N Foster St, Mitchell, SD 57301. The listed phone number is (605) 995-2000.

What is Avera Queen Of Peace's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Avera Queen Of Peace enrolled in Medicare?

Yes. Avera Queen Of Peace is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Avera Queen Of Peace?

According to the CMS Revalidation Reassignment List (October 2026 release), 227 clinicians in 28 Medicare specialties reassign their Medicare billing to Avera Queen Of Peace. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (38), Diagnostic Radiology (35) and Internal Medicine (28). Of these, 24 practice at this address and 71 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Avera Queen Of Peace was last updated on August 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.