AVERA QUEEN OF PEACE
NPI 1124308010
Family Medicine in Mitchell, SD
NPI Status: Active since August 23, 2011
Contact Information
1900 GRASSLAND DR
MITCHELL, SD
ZIP 57301
Phone: (605) 995-7000
Fax: (605) 995-7052
- Organization
- Family Medicine
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 43D0707587
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 02-08-2027
About AVERA QUEEN OF PEACE
This page provides the complete NPI Profile along with additional information for Avera Queen Of Peace, a primary care provider established in Mitchell, South Dakota operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1124308010 assigned on August 2011. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated January 2026. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's
- NPI
- 1124308010
- Provider Legal Name
- AVERA QUEEN OF PEACE
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1900 GRASSLAND DR MITCHELL, SD 57301
- Location Phone
- (605) 995-7000
- Location Fax
- (605) 995-7052
- Mailing Address
- PO BOX 86370 SIOUX FALLS, SD 57118
- Mailing Phone
- (605) 322-4933
- Mailing Fax
- (605) 995-7052
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 08-23-2011
- Last Update Date
- 01-22-2026
- Code Navigator
A primary care provider (PCP) like Avera Queen Of Peace sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Avera Queen Of Peace is a medicare supplier with PTAN 20627897 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs.
Location Map
Secondary Locations
- 818 W Havens Ave Ste 900
Mitchell, SD 57301
(605) 996-7526 - 818 W Havens Ave Ste 800
Mitchell, SD 57301
(605) 996-7526
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- ConnectPlus $0 Gold - PPO
- ConnectPlus $0 Silver - PPO
- ConnectPlus $10,600 HSA Eligible HDHP - PPO
- ConnectPlus $1800 - PPO
- ConnectPlus $4500 - PPO
- ConnectPlus $6500 HSA Eligible HDHP - PPO
- ConnectPlus $7500 HSA Eligible HDHP - PPO
- ConnectPlus MyWeighForward $2000 - PPO
- ConnectPlus MyWeighForward $6000 - PPO
- ConnectPlus Standard $2000 - PPO
- ConnectPlus Standard $6000 - PPO
- ConnectPlus Standard $7500 HSA Eligible HDHP - PPO
- DirectConnect $0 Gold - HMO
- DirectConnect $0 Silver - HMO
- DirectConnect $1800 - HMO
- DirectConnect $4500 - HMO
- DirectConnect $6500 HSA Eligible HDHP - HMO
- DirectConnect $7500 HSA Eligible HDHP - HMO
- DirectConnect MyWeighForward $2000 - HMO
- DirectConnect MyWeighForward $6000 - HMO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - HMO
- Medica Insure Bronze $0 Copay PCP Visits - EPO
- Medica Insure Bronze Premier - EPO
- Medica Insure Bronze Share - EPO
- Medica Insure Expanded Bronze Standard - EPO
- Medica Insure Gold $0 Copay PCP Visits - EPO
- Medica Insure Gold Share - EPO
- Medica Insure Gold Standard - EPO
- Medica Insure Silver $0 Copay PCP Visits - EPO
- Medica Insure Silver Share - EPO
- Medica Insure Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20627897
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy.
- Competitive Bidding
- NO
Supplies List
- Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 43D0707587
- Facility Type
- Hospital
- Certificate Effective Date
- February 09, 2025
- Certificate Expiration Date
- February 08, 2027
- Laboratory Director
- DR. BRIAN J. TJARKS
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Avera Queen Of Peace on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124308010, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MITCHELL, SD 57301
MITCHELL, SD 57301
MITCHELL, SD 57301
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124308010, enumerated as an "organization" on August 23, 2011.
The provider is located at 1900 GRASSLAND DR MITCHELL, SD 57301 and the phone number is (605) 995-7000.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Avera Health Plans and Medica. Please consult your insurance carrier or call the provider to verify.
