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

Active since June 18, 2009CLIA 43D2271860 · Waiver
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: August 09, 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 holds a CLIA Waiver certificate valid through November 8, 2026 and 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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 43D2271860

Avera Medical Group Occupational Medicine · Mitchell, SD
Active · expires Nov 8, 2026
CLIA Number43D2271860
Laboratory TypePractitioner Other
Certificate Effective DateNovember 9, 2024
Certificate Expiration DateNovember 8, 2026
Laboratory DirectorTrevor A. Meaney
Laboratory Phone(605) 995-7023
Laboratory LocationAvera Medical Group Occupational Medicine1900 Grassland Dr, Mitchell, SD 57301
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DARLA EDINGER MD
Internal Medicine
525 N FOSTER ST
MITCHELL, SD 57301
Davison County (605) 995-5701
JACKIE WENZ RN
Registered Nurse
525 N FOSTER ST
MITCHELL, SD 57301
Davison County (605) 995-2440
AVERA QUEEN OF PEACE
Radiology (Diagnostic Radiology)
525 N FOSTER ST
MITCHELL, SD 57301
Davison County (605) 995-6337
AHNA BUNTROCK MD
Obstetrics & Gynecology
525 N FOSTER ST
MITCHELL, SD 57301
Davison County (605) 995-2000
MR. DAN BLOODGOOD
Nurse Anesthetist, Certified Registered
525 N FOSTER ST
MITCHELL, SD 57301
Davison County (605) 995-2000
HEIDI M GEHRKE
Nurse Practitioner (Family)
525 N FOSTER ST
MITCHELL, SD 57301
Davison County (605) 995-2000
TERESA L ALDRICH
Occupational Therapist
525 N FOSTER ST
MITCHELL, SD 57301
Davison County (605) 995-2000
KELLY JO MCDERMOTT
Nurse Practitioner (Family)
525 N FOSTER ST
MITCHELL, SD 57301
Davison County (605) 995-5701

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.

Does Avera Queen Of Peace hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 43D2271860) is associated with this NPI, valid through November 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Avera Queen Of Peace accept?

Health plans from Medica list Avera Queen Of Peace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 5 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.