| Avera Medical Group Gettysburg | |
|
606 E Garfield Ave Ste C Gettysburg SD 57442-1325 | |
| (605) 765-2273 | |
| Not Available |
| Full Name | Avera Medical Group Gettysburg |
|---|---|
| Speciality | Internal Medicine |
| Location | 606 E Garfield Ave Ste C, Gettysburg, South Dakota |
| Authorized Official Name and Position | Shantel Krebs (INTERIM CEO) |
| Authorized Official Contact | 6052243144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Medical Group Gettysburg Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-4933 | Avera Medical Group Gettysburg 606 E Garfield Ave Ste C Gettysburg SD 57442-1325 Ph: (605) 765-2273 |
| NPI Number | 1366091357 |
|---|---|
| Provider Enumeration Date | 09/11/2019 |
| Last Update Date | 04/24/2023 |
| Certification Date | 04/24/2023 |
| Medicare PECOS PAC ID | 4284619362 |
|---|---|
| Medicare Enrollment ID | O20191025000756 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366091357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 363A00000X | Physician Assistant | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| Provider Name | Stephen J Knoble |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245230937 PECOS PAC ID: 1052301330 Enrollment ID: I20040518000058 |
| Provider Name | Vincent E Furrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053365445 PECOS PAC ID: 8426038639 Enrollment ID: I20040902001402 |
| Provider Name | Darrell W Plumage |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013938844 PECOS PAC ID: 1254380728 Enrollment ID: I20050121000748 |
| Provider Name | Rena J Robbennolt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851370746 PECOS PAC ID: 4486695053 Enrollment ID: I20050513000720 |
| Provider Name | Cindy D Erwin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982600276 PECOS PAC ID: 3173555125 Enrollment ID: I20050909000931 |
| Provider Name | Eldon R Becker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023083797 PECOS PAC ID: 3779576434 Enrollment ID: I20050919001010 |
| Provider Name | Brent J Lindbloom |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700851011 PECOS PAC ID: 4587657275 Enrollment ID: I20050919001027 |
| Provider Name | Debra K Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285611616 PECOS PAC ID: 3173587342 Enrollment ID: I20051116000669 |
| Provider Name | Kasey J Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346246493 PECOS PAC ID: 3779565593 Enrollment ID: I20060113000097 |
| Provider Name | Sean C Halligan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174504658 PECOS PAC ID: 4486661410 Enrollment ID: I20060504000412 |
| Provider Name | Chad E Stapp |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1952438996 PECOS PAC ID: 7113024340 Enrollment ID: I20070523000147 |
| Provider Name | Shawna M Schmidt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770603888 PECOS PAC ID: 7214023639 Enrollment ID: I20071017000337 |
| Provider Name | Paul J Olson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770538019 PECOS PAC ID: 4082668959 Enrollment ID: I20071023000582 |
| Provider Name | Tarek H Mahrous |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225046436 PECOS PAC ID: 1557397486 Enrollment ID: I20080514000761 |
| Provider Name | Chad J Carda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013139823 PECOS PAC ID: 3375637671 Enrollment ID: I20080821000093 |
| Provider Name | Darci J Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568436236 PECOS PAC ID: 3375619893 Enrollment ID: I20080908000370 |
| Provider Name | Bruce a Watt |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1922052075 PECOS PAC ID: 4082621115 Enrollment ID: I20090608000359 |
| Provider Name | Michael David Hibbard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629026422 PECOS PAC ID: 0244247377 Enrollment ID: I20100105000005 |
| Provider Name | Paul L Carpenter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598723603 PECOS PAC ID: 5698782720 Enrollment ID: I20100118000115 |
| Provider Name | Christopher J Paa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265486138 PECOS PAC ID: 5294894556 Enrollment ID: I20100330000100 |
| Provider Name | Christopher M Stanton |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1457323081 PECOS PAC ID: 0749246809 Enrollment ID: I20100913000422 |
| Provider Name | Raymond H Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396733705 PECOS PAC ID: 8729095856 Enrollment ID: I20101008000292 |
| Provider Name | Katie L Urban |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720345242 PECOS PAC ID: 8224284831 Enrollment ID: I20120815000260 |
| Provider Name | Erin Tobin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235430042 PECOS PAC ID: 9931395654 Enrollment ID: I20130510000311 |
| Provider Name | Riley a Lamb |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588815641 PECOS PAC ID: 1850527227 Enrollment ID: I20131114000324 |
| Provider Name | Connie M Belford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588095038 PECOS PAC ID: 2466676762 Enrollment ID: I20140606000054 |
| Provider Name | Warren E Shaulis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497160436 PECOS PAC ID: 1759608243 Enrollment ID: I20150320002037 |
| Provider Name | Meghan J Torgerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134584584 PECOS PAC ID: 8628367471 Enrollment ID: I20160517002218 |
| Provider Name | Teresa L Mead-hahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013452325 PECOS PAC ID: 4486931383 Enrollment ID: I20170502001392 |
| Provider Name | Angela M Mackner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275058216 PECOS PAC ID: 0941567168 Enrollment ID: I20171127000787 |
| Provider Name | Jenna L Wickersham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538579271 PECOS PAC ID: 5799905345 Enrollment ID: I20180201002720 |
| Provider Name | Brian Collins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740728591 PECOS PAC ID: 0345527271 Enrollment ID: I20180516001786 |
| Provider Name | Brittany B Kerr |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609357623 PECOS PAC ID: 4385989573 Enrollment ID: I20181217000913 |
| Provider Name | Jennifer L Byer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487973525 PECOS PAC ID: 9133359789 Enrollment ID: I20190325001967 |
| Provider Name | Jada a Rausch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578028981 PECOS PAC ID: 9537401393 Enrollment ID: I20190425002460 |
| Provider Name | Thomas M Waterbury |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1225392160 PECOS PAC ID: 2062658909 Enrollment ID: I20190715001786 |
| Provider Name | Daylon D Wigart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134682933 PECOS PAC ID: 8729318738 Enrollment ID: I20190917004077 |
| Provider Name | John F Wagener |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972879161 PECOS PAC ID: 5496003949 Enrollment ID: I20200805000798 |
| Provider Name | Lucinda K Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558593954 PECOS PAC ID: 5294154753 Enrollment ID: I20201001002641 |
| Provider Name | Adam Glanzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932763141 PECOS PAC ID: 4385055441 Enrollment ID: I20201120000324 |
| Provider Name | Shelby Schoenfelder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942898739 PECOS PAC ID: 0547675795 Enrollment ID: I20210219001962 |
| Provider Name | Drew G Messerschmidt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467848655 PECOS PAC ID: 0749560118 Enrollment ID: I20210713003838 |
| Provider Name | Maggie L Bistodeau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407524622 PECOS PAC ID: 7214326198 Enrollment ID: I20211115002350 |
| Provider Name | Alyssa J Kahler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598416653 PECOS PAC ID: 0345633673 Enrollment ID: I20220209002814 |
| Provider Name | Jonathan J Werner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619474228 PECOS PAC ID: 5294082996 Enrollment ID: I20220930000937 |
| Provider Name | Stefanie G Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093442808 PECOS PAC ID: 9335515345 Enrollment ID: I20221108000650 |
| Provider Name | Kacie N Jacobsen-ahlers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518609841 PECOS PAC ID: 2163892787 Enrollment ID: I20221222002495 |
| Provider Name | Karalynn N Kuhn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205579455 PECOS PAC ID: 6800267758 Enrollment ID: I20230201000411 |
| Provider Name | Jalen J Lamb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487235008 PECOS PAC ID: 1557767746 Enrollment ID: I20230215000917 |
| Provider Name | Mary Anne Kidwell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649365289 PECOS PAC ID: 9234119074 Enrollment ID: I20241016004119 |
| Provider Name | Dominic Shuttleworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215673504 PECOS PAC ID: 5294101002 Enrollment ID: I20251015001163 |
| Provider Name | Darci NP Leisenring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447126248 PECOS PAC ID: 8426543752 Enrollment ID: I20251223003452 |
Community Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 608 E Garfield Ave, Gettysburg, SD 57442 Phone: 605-765-2273 Fax: 605-765-2273 |