AVERA MEDICAL GROUP ORTHOPEDICS & SPORTS MEDICINE – NPI #1710184569
Prosthetic/Orthotic Supplier
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
AVERA MEDICAL GROUP ORTHOPEDICS & SPORTS MEDICINE is a DME Supplier located in MITCHELL, SD. NPPES has assigned the NPI number 1710184569 to AVERA MEDICAL GROUP ORTHOPEDICS & SPORTS MEDICINE on June 27, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AVERA MEDICAL GROUP ORTHOPEDICS & SPORTS MEDICINE” is a dba name, the actual legal business name for this organization is AVERA QUEEN OF PEACE. The primary taxonomy selected by this provider is 335E00000X from the Health Care Provider Taxonomy code set, which is classified as Prosthetic/Orthotic Supplier.
The NPI profile was previously updated about 6 years ago on Aug 20, 2020. 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 MEDICAL GROUP ORTHOPEDICS & SPORTS MEDICINE below.
NPI Profile for
AVERA QUEEN OF PEACE
(about 19 years ago)
SUITE 200
MITCHELL, SD 57301-2969 Phone: (605) 996-3963 Fax: (605) 996-0718
PRESIDENT/CEO
Phone: (605) 668-8322
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.
Identifiers for AVERA MEDICAL GROUP ORTHOPEDICS & SPORTS MEDICINE
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| MEDICAID | SD | 0100130 |
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 |
|---|---|---|
| 335E00000X - Prosthetic/Orthotic Supplier (Primary) |
SD | 100-1023 |
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.