Healthcare Provider Details

I. General information

NPI: 1720326713
Provider Name (Legal Business Name): AVERA ST MARYS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2013
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E SIOUX AVE
PIERRE SD
57501-3323
US

IV. Provider business mailing address

PO BOX 86370
SIOUX FALLS SD
57118-6370
US

V. Phone/Fax

Practice location:
  • Phone: 605-224-5901
  • Fax: 605-945-3244
Mailing address:
  • Phone: 605-322-4933
  • Fax: 605-504-9489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: SHANTEL KREBS
Title or Position: CEO
Credential:
Phone: 605-224-3144