Healthcare Provider Details
I. General information
NPI: 1619355633
Provider Name (Legal Business Name): AVERA ST LUKE'S
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2015
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
805 1ST AVE SE
ABERDEEN SD
57401
US
IV. Provider business mailing address
PO BOX 4400
ABERDEEN SD
57402-4400
US
V. Phone/Fax
- Phone: 605-622-5878
- Fax: 605-622-5888
- Phone: 605-622-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
BJERKNES
Title or Position: REGIONAL PRESIDENT/CEO
Credential:
Phone: 605-622-2807