Healthcare Provider Details

I. General information

NPI: 1013143296
Provider Name (Legal Business Name): AVERA ST. LUKE'S
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S STATE ST STE 113
ABERDEEN SD
57401-4502
US

IV. Provider business mailing address

PO BOX 86370
SIOUX FALLS SD
57118-6370
US

V. Phone/Fax

Practice location:
  • Phone: 605-225-0378
  • Fax: 605-225-7919
Mailing address:
  • Phone: 605-322-4933
  • Fax: 605-225-7919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10525
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL J BJERKNES
Title or Position: PRESIDENT/CEO
Credential:
Phone: 605-622-5125