AVERA QUEEN OF PEACE — NPI 1881964484 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1881964484

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208D00000X (CMS 01)

Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice

Box 32 Service Location & ZIP+4

801 3RD ST SW, DE SMET, SD, 57231-2224

✓ 9-Digit EDI 837 ZIP+4 (57231-2224)

Practice Phone & Referral Fax

(605) 854-3834

Fax: (605) 854-3878

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1881964484 (AVERA QUEEN OF PEACE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1881964484` (NPI-2 Organization / Facility)
Provider / Legal Name	AVERA QUEEN OF PEACE
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice NUCC Code: `208D00000X` (General Practice)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	801 3RD ST SW, DE SMET, SD, 57231-2224
Practice Telephone / Fax	Tel: (605) 854-3834 \| Fax: (605) 854-3878
Administrative Mailing Address	PO BOX 86370, SIOUX FALLS, SD, 57118-6370
Enumeration & Last Sync	Enumerated: 2012-01-12 \| CMS Record Updated: 2026-01-22
Authorized Official	HILARY ROCKWELL (Regional President/CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

801 3RD ST SW, DE SMET, SD, 57231-2224

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Plain-English Taxonomy & CMS Crosswalk (208D00000X)

What Does Taxonomy Code 208D00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208D00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 01 (Physician/General Practice) • CMS Code 99 (Physician/Undefined Physician type[6])
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified General Practice for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AVERA QUEEN OF PEACE)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363A00000X` — Physician Assistant Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant	State: N/A \| License: `Verified` \| Primary: Secondary
`208D00000X` — General Practice Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — General Practice	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AVERA QUEEN OF PEACE (NPI #1881964484)