Healthcare Provider Details

I. General information

NPI: 1124459391
Provider Name (Legal Business Name): AVERA ST. LUKE'S
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 8TH AVE NW STE A
ABERDEEN SD
57401-1865
US

IV. Provider business mailing address

PO BOX 86370
SIOUX FALLS SD
57118-6370
US

V. Phone/Fax

Practice location:
  • Phone: 605-226-2663
  • Fax: 605-226-6795
Mailing address:
  • Phone: 605-322-4933
  • Fax: 605-504-9489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

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