Avera Queen of Peace
Avera Queen of Peace is a healthcare organization registered as Physician Assistant in Mitchell, SD, holding Type 2 (organization) NPI 1629361720 since 2011. The authorized official on file is Douglas Ekeren, President/Ceo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1629361720 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Avera Queen of Peace |
| Other name | <Unavail> |
| Practice address | 1900 GRASSLAND DR, Mitchell, SD, 57301 |
| Phone | 6059957000 |
| Enumeration date | 2011-05-23 |
| Last updated in NPPES | 2020-08-20 |
Authorized official
| Name | Douglas Ekeren |
|---|---|
| Title | President/Ceo |
| Phone | 6056688322 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | Secondary | — | — |
| 363A00000X | Physician Assistant | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2002248 | Medicaid | SD | — |
Copy-ready billing details
Provider: Avera Queen of Peace NPI: 1629361720 Taxonomy: 363A00000X (Physician Assistant) Address: 1900 GRASSLAND DR, Mitchell, SD, 57301
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1699731901 | Andrew Reynolds | Individual | Surgery Physician | Mitchell, SD |
| 1306943576 | Xenofon Papadopoulos | Individual | Urology Physician | Mitchell, SD |
| 1114144375 | Aaron Baas | Individual | Family Medicine Physician | Mitchell, SD |
| 1134326861 | Avera Queen of Peace | Organization | Surgery Physician | Mitchell, SD |
| 1861639197 | Avera Queen of Peace | Organization | Pediatrics Physician | Mitchell, SD |
| 1801193453 | Avera Queen of Peace | Organization | Radiology Clinic/Center | Mitchell, SD |
| 1649577297 | Avera Queen of Peace | Organization | Clinical Medical Laboratory | Mitchell, SD |
| 1528348406 | Avera Queen of Peace | Organization | Internal Medicine Physician | Mitchell, SD |
Verify this record
Cross-check NPI 1629361720 against the authoritative CMS record: view Avera Queen of Peace on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Avera Queen of Peace?
Who is the authorized official for Avera Queen of Peace?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-08-20.