Healthcare Provider Details

I. General information

NPI: 1558280263
Provider Name (Legal Business Name): AVERA ST MARYS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E SIOUX AVE
PIERRE SD
57501-3323
US

IV. Provider business mailing address

801 E SIOUX AVE
PIERRE SD
57501-3323
US

V. Phone/Fax

Practice location:
  • Phone: 605-224-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: SHANTEL KREBS
Title or Position: REGIONAL PRESIDENT & CEO
Credential:
Phone: 605-351-5916