AVERA ST MARYS HOSPITAL - ESRD – NPI #1144238619
Clinic/Center

AVERA ST MARYS HOSPITAL - ESRD is an AHC clinic located in PIERRE, SD. NPPES has assigned the NPI number 1144238619 to AVERA ST MARYS HOSPITAL - ESRD on August 03, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AVERA ST MARYS HOSPITAL - ESRD” is a dba name, the actual legal business name for this organization is AVERA ST MARYS. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 4 years ago on Jul 15, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AVERA ST MARYS HOSPITAL - ESRD below.

NPI Profile for
AVERA ST MARYS

NPI Number
1144238619
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AVERA ST MARYS
Doing Business As (dba): AVERA ST MARYS HOSPITAL - ESRD
Primary location
801 E SIOUX AVE
PIERRE, SD 57501-3323
Phone: (605) 224-3100 Fax:
Mailing address
PO BOX 5045
CBO PALM PLACE PROV ENROLLMT
SIOUX FALLS, SD 57117-5045
Phone: (605) 322-6428 Fax:
Organization Subpart
No
Authorized Official
MIKEL HOLLAND
CEO/PRESIDENT
Phone: (605) 224-3144
Updated
Certification Date
Jul 15, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)		 SD 432305

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.