Avera McKennan
Organization Active NPI Critical Access Hospital Clinic/Center · Milbank, SD
NPI 1013024009 · NPPES record last updated Jan 9, 2017
Key facts
- NPI
- 1013024009
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital Clinic/Center 261QC0050X
- License
- 48451 (SD)
- Legal business name
- AVERA MCKENNAN
- Practice address
- 301 Flynn Dr
Milbank, SD 57252-1502 - Phone
- (605) 432-4538
- Fax
- (605) 432-5412
- NPI assigned
- Aug 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Julie Norton
- Title
- VP/Cfo
- Phone
- (605) 322-6375
Member of 1
Practitioners 50
-
Colette A Ducheneaux, M.D.
-
Austin Eggers, MD
-
Emelia Nelson, NP
-
Meridith Leigh Biel, APRN,CNP
-
Jenna Karels, CNP
-
Julia Agnes Abraham, PA-C
-
Bradley E Adams, PAC
-
Alec Michael Baker, PA-C
-
Jackie Joanne Bau, FNP-C
-
Lisa M Bucklin, CNP
-
Jerry W Chesley, PA
-
Shawn R Culey, MD
-
Mary C Dressing, LPC-MH, RD, LN
-
Carmen Hendrix, NP-PMH
-
Matt E. Herber, MD
-
Joshua Hughes, PA-C
-
Tad Jacobs, DO
-
Ashley Johnson, PA-C
-
Brittany Bo Kerr, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000117 | SD | Part B Supplier - Clinic/Group Practice | 0345157103 |
Receives reassigned benefits from 1,418 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital Clinic/Center | 261QC0050X | 48451 | SD | Yes |
Addresses
Primary practice location
301 Flynn Dr
Milbank, SD 57252-1502
Mailing address
301 Flynn Dr
Milbank, SD 57252-1502
Phone (605) 432-4538
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 413S6MI | Other | MN | MN BLUE CROSS-AHC PROV# |
| 4996299 | Other | SD | SD BLUE CROSS AHC PROV# |
| 9204610 | Other | SD | DAKOTACARE AHC PROV# |
Other names
- Milbank Area Hospital After Hours Clinic
Other providers in Milbank, SD
- Nevin John Andreas
- Avera at Home
- Avera at Home
- Avera McKennan
- Avera McKennan
- Avera McKennan
- Avera McKennan
- Avera McKennan
All providers in Milbank, SD · Critical Access Hospital Clinic/Center in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.