AVERA MEDICAL GROUP PODIATRY
NPI 1871771279
Podiatrist in Aberdeen, SD

Q: What is Avera St. Luke's's NPI number?

The NPI number for Avera St. Luke's is 1871771279. It was assigned to this organization in the NPPES registry on February 7, 2008. The provider is doing business as Avera Medical Group Podiatry.

Q: What is Avera St. Luke's's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Q: When was this NPI record last updated?

The NPPES record for Avera St. Luke's was last updated on August 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since February 07, 2008

310 S PENN ST STE 203, ABERDEEN, SD 57401(605) 622-2570(605) 622-2571 Get Directions Write a Review

NPPES record last updated: August 18, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 18, 2022, Apr 2, 2020, Aug 16, 2018 and 1 more (4 updates tracked since 2017).

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About Avera Medical Group Podiatry NPPES

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

AVERA MEDICAL GROUP PODIATRY (NPI 1871771279) is a healthcare organization registered as a podiatrist in Aberdeen, South Dakota and active in the NPI registry since February 2008. The organization lists Daniel J Bjerknes, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1871771279

Entity TypeOrganization

Primary Taxonomy213E00000X

Legal Business NameAVERA ST. LUKE'S

Location Address310 S PENN ST STE 203Aberdeen, SD 57401-4553

Mailing AddressPo Box 860674Minneapolis, MN 55486-0001 · (605) 622-2570 · Fax (605) 622-2571

Phone(605) 622-2570

Fax(605) 622-2571

Organization SubpartNo

Authorized OfficialDaniel J BjerknesPresident/ceo · (605) 622-5125

Enumeration DateFebruary 7, 2008

Last NPPES UpdateAugust 18, 20224 updates tracked since enumeration

NPPES CertifiedAugust 18, 2022

✔ NPI 1871771279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers

Taxonomy Code213E00000X

License✔ Licensed in SD · 10525

Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

310 S PENN ST STE 203, Aberdeen, SD 57401

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Other Names 1

Doing Business AsAvera Medical Group Podiatry

Other Identifiers 2

Medicaid14712ND

Other9255744SD · Dakotacare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

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

KRISTINE LYNN FASTENAU NP

Nurse Practitioner (Adult Health)