=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134326861
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AVERA QUEEN OF PEACE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2007
-----------------------------------------------------
Last Update Date | 01/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1900 GRASSLAND DR
-----------------------------------------------------
City | MITCHELL
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57301-6205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-995-7000
-----------------------------------------------------
Fax | 605-995-4957
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 86370
-----------------------------------------------------
City | SIOUX FALLS
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57118-6370
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-322-4933
-----------------------------------------------------
Fax | 605-504-9489
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REGIONAL PRESIDENT / CEO
-----------------------------------------------------
Name | HILARY R. ROCKWELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 605-995-2200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------