Active NPI
Avera McKennan
Doing business as Avera Medical Group University Psychiatry Associates Sioux Falls
- Psychiatry Physician
- Sioux Falls, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- AVERA MCKENNAN
- Doing business as
- Avera Medical Group University Psychiatry Associates Sioux Falls
Avera Psychiatry Sioux Falls - Practice address
- 4400 W 69TH St Ste 1500
Sioux Falls, SD 57108-8171 - Phone
- (605) 322-5700
- Fax
- (605) 322-5704
- NPI assigned
- Feb 7, 2006
- Last updated
- Mar 12, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ronald J Place
- Title
- Ceo/President
- Phone
- (605) 322-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | NU | Primary |
Addresses
Primary practice location
4400 W 69TH St Ste 1500
Sioux Falls, SD 57108-8171
Mailing address
PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0040470 | Other | SD | BCBS |
| 040121002 | Other | MN | PRIMEWEST |
| 22591 | Other | IA | BCBS IA |
| 50M77UN | Other | MN | BLUE PLUS/CC SYSTEMS |
| 996458400 | Medicaid | MN | |
| 81G97AV | Other | MN | BLUE PLUS/CCS |
| 0561456 | Medicaid | IA | |
| 81G87AV | Other | MN | BCBS MN |
| 86467 | Other | SD | HEALTHPARTNERS |
Other names 2
- Avera Medical Group University Psychiatry Associates Sioux Falls
- Avera Psychiatry Sioux Falls
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD, MN, IA
Enrollment records 4
| 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 |
| O20040109001102 | MN | Part B Supplier - Clinic/Group Practice | 0345157103 |
Receives reassigned benefits from 81 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Worthington, MN; Windom, MN; Tyler, MN; Slayton, MN; Pipestone, MN; Lakefield, MN; Ortonville, MN; Marshall, MN… |
| O20040206000384 | IA | Part B Supplier - Clinic/Group Practice | 0345157103 |
Receives reassigned benefits from 91 practitioners 25 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rock Valley, IA; Spirit Lake, IA; Spencer, IA; Sioux Center, IA; Sibley, IA; Rock Rapids, IA; Milford, IA; Mason City, IA… |
| O20040506000713 | SD | Part A Provider - Hospital | 0345157103 |
22 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1013980598. Details of each certification follow.
Hospital certification: CCN 430016
- Legal name
- AVERA MCKENNAN
- Doing business as
- AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Nov 3, 2011
- Beds
- 505
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation
- Incorporated
- May 23, 1925 in SD
- Enrollment address
- 1325 S Cliff Ave
Sioux Falls, SD 57105-1007 - Hospital subgroups
- General, Acute care
Related certifications (CCN) 3
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
- Psychiatric Hospital Unit
- Sioux Falls, SD
- NPI 1164445250
-
dba Avera McKennan Hospital and University Health Center - Rehab Unit
- Rehabilitation Hospital Unit
- Sioux Falls, SD
- NPI 1215951629
-
dba Avera McKennan Hospital and University Health Center
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1568460772
Hospital unit
Other NPIs on the same Medicare enrollment 47
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Avera Medical Group Urogynecology Sioux Falls
- Obstetrics & Gynecology Physician
- Sioux Falls, SD
- NPI 1003188269
O20040109001102, O20040506000713
-
dba Avera Medical Group Rheumatology Sioux Falls
- Rheumatology Physician
- Sioux Falls, SD
- NPI 1013177393
O20040206000384, O20040506000713
-
dba Avera Medical Group Oncology and Hematology Sioux Falls
- Hematology & Oncology Physician
- Sioux Falls, SD
- NPI 1033185582
O20040109001102, O20040206000384
-
dba Avera Interventional Radiology
- Diagnostic Radiology Physician
- Sioux Falls, SD
- NPI 1053680678
O20040109001102, O20040206000384
-
dba Avera Medical Group Orthopedics and Sports Medicine
- Orthopaedic Surgery Physician
- Sioux Falls, SD
- NPI 1093262131
O20040109001102, O20040206000384, O20040506000713
-
dba Avera Nephrology
- Nephrology Physician
- Sioux Falls, SD
- NPI 1104892892
O20040109001102, O20040206000384
-
dba Avera Medical Group Brain and Spine Institute
- Neurological Surgery Physician
- Sioux Falls, SD
- NPI 1114113693
O20040206000384, O20040506000713
-
dba Avera Medical Group Physical Medicine and Rehabilitation Sioux Falls
- Physical Medicine & Rehabilitation Physician
- Sioux Falls, SD
- NPI 1134195332
O20040109001102, O20040206000384, O20040506000713
-
dba Avera McKennan Hospital and University Health Center - Diabetic Ed
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1154531630
O20040506000713
-
dba Avera Medical Group McHale Institute
- Hematology & Oncology Physician
- Sioux Falls, SD
- NPI 1164780201
O20040109001102
-
dba Avera Gastroenterology Sioux Falls
- Gastroenterology Physician
- Sioux Falls, SD
- NPI 1194799882
O20040506000713
Care Compare: Hospital
Medicare Care Compare- Listed as
- Avera McKennan Hospital & University Health Center
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider DirectoryLocations
4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700
Ownership & related parties
All disclosed owners & managing parties 22
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Alisa L Reindl | Corporate Director | Jul 1, 2021 | |
| James Francis Dover | Corporate Officer | Oct 23, 2023 | |
| Tamera L Sturm | Corporate Director | Jul 1, 2025 | |
| Van Fishback | Corporate Director | Jul 1, 2018 | |
| Candyce C Chrystal | Corporate Director | Jul 1, 2024 | |
| Harriet Yocum | Corporate Director | Jul 1, 2021 | |
| Jennifer Bunkers | Corporate Director | Jul 1, 2021 | |
| Randy Knecht | Corporate Director | Jul 1, 2018 | |
| Jawad Nazir | Corporate Director | Jul 1, 2020 | |
| Lucille F Welbig | Corporate Director | Jul 1, 2015 | |
| Joseph Patrick Costello | Corporate Director | Jul 1, 2017 | |
| Sanaa Abourezk | Corporate Director | Jul 1, 2024 | |
| Amanda Marie Schutz | Contracted Managing Employee | Jun 15, 2018 | |
| Ryan Boschee | Corporate Director | Jul 1, 2024 | |
| Jennifer Kirby | Corporate Director | Jul 1, 2020 | |
| Ronald J. Place | Corporate Officer | Jun 5, 2023 | |
| Operational/Managerial Control | Jun 5, 2023 | ||
| Julie Lautt | Corporate Officer | Mar 1, 2020 | |
| Mary C Curran | Corporate Director | Jul 1, 2017 | |
| Avera Health | 5% Or Greater Direct Ownership Interest | Jul 1, 2000 | |
| Operational/Managerial Control | Jul 1, 2000 | ||
| Roxanne P Seifert | Corporate Director | Jul 1, 2024 | |
| Cristina a Hill Jensen | Corporate Director | Jul 1, 2018 | |
| Benjamin M Solomon | Corporate Director | Jul 1, 2022 |
Owners & managing parties with NPI records 5
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Gastroenterology Physician
- Sioux Falls, SD
- NPI 1760691794
Corporate Director
-
- Hematology & Oncology Physician
- Sioux Falls, SD
- NPI 1912107368
Corporate Director
Practitioners & affiliated clinicians
Practitioners 80
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- Sioux Falls, SD
- NPI 1982198776
-
- Psychiatry Physician
- Sioux Falls, SD
- NPI 1467072066
-
- Neurology Physician
- Sioux Falls, SD
- NPI 1487888012
-
- Counselor
- Sioux Falls, SD
- NPI 1528813011
-
- Child & Adolescent Psychiatry Physician
- Sioux Falls, SD
- NPI 1134389299
-
- Child & Adolescent Psychiatry Physician
- Sioux Falls, SD
- NPI 1518488501
-
- Psychiatry Physician
- Sioux Falls, SD
- NPI 1285216788
-
- Psychiatry Physician
- Sioux Falls, SD
- NPI 1366538233
-
- Child & Adolescent Psychiatry Physician
- Sioux Falls, SD
- NPI 1730265752
-
- Clinical Social Worker
- Sioux Falls, SD
- NPI 1649083528
-
- Addiction Psychiatry Physician
- Sioux Falls, SD
- NPI 1023547486
-
- Psychiatry Physician
- Sioux Falls, SD
- NPI 1780793976
Affiliated clinicians 1,295
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Anatomic Pathology & Clinical Pathology Physician
- Sioux Falls, SD
- NPI 1013159037
Hospital
-
- Hospitalist Physician
- Sioux Falls, SD
- NPI 1841866340
-
- Clinical Cardiac Electrophysiology Physician
- Sioux Falls, SD
- NPI 1578683249
Hospital
-
- Internal Medicine Physician
- Sioux Falls, SD
- NPI 1457091993
Hospital
-
- Hospitalist Physician
- Sioux Falls, SD
- NPI 1285367979
-
- Certified Registered Nurse Anesthetist
- Sioux Falls, SD
- NPI 1124252648
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773273600000",
"number": "1013980598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86370",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571186370",
"telephone_number": "605-322-7510",
"fax_number": "605-322-6475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 W 69TH ST STE 1500",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571088171",
"telephone_number": "605-322-5700",
"fax_number": "605-322-5704"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVERA MCKENNAN",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-07",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A",
"authorized_official_last_name": "PLACE",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CEO/PRESIDENT",
"authorized_official_telephone_number": "605-322-8000"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0040470",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIMEWEST",
"identifier": "040121002",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IA",
"identifier": "22591",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE PLUS/CC SYSTEMS",
"identifier": "50M77UN",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "996458400",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE PLUS/CCS",
"identifier": "81G97AV",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0561456",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN",
"identifier": "81G87AV",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "86467",
"state": "SD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Avera Medical Group University Psychiatry Associates Sioux Falls",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Avera Psychiatry Sioux Falls",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Sioux Falls, SD
- Avera McKennan (Avera Medical Group Urogynecology Sioux Falls)
- Avera McKennan (Avera Medical Group Rheumatology Sioux Falls)
- Avera McKennan (Avera Medical Group)
- Avera McKennan (Avera Medical Group Addiction Medicine)
- Avera McKennan
- Avera McKennan (AveraNow)
- Avera McKennan (Avera Medical Group Oncology and Hematology Sioux Falls)
- Avera McKennan (Avera Medical Group McGreevy 69th & Minnesota Pediatrics)
- Avera McKennan (Avera Prince of Peace Assisted Living)
- Avera McKennan (Avera Interventional Radiology)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.