Avera McKennan

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AVERA MCKENNAN

Doing business as

Avera Medical Group-Internal Medicine-Women's

Practice address

116 W 69TH St
Sioux Falls, SD 57108-6418

Phone

(605) 322-1530

Fax

(605) 322-1531

NPI assigned

Jun 5, 2012

Last updated

May 13, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julie Norton

Title

Cfo

Phone

(605) 322-8000

Specialties & licenses 1

Addresses

Other names 1

• Avera Medical Group-Internal Medicine-Women's Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

Practitioners 8

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.

• Alec Michael Baker, PA-C

  • Physician Assistant
  • Dell Rapids, SD
  • NPI 1689553729
  NPD
• Joshua Hughes, PA-C

  • Physician Assistant
  • Dell Rapids, SD
  • NPI 1487322764
  NPD
• Ashley Johnson, PA-C

  • Physician Assistant
  • Vermillion, SD
  • NPI 1942728183
  NPD
• Daniel J Kvale, PAC

  • Physician Assistant
  • Bison, SD
  • NPI 1750356465
  NPD
• Ashley Marie Ruhaak, CNP

  • Primary Care Nurse Practitioner
  • Wagner, SD
  • NPI 1104687235
  NPD
• Brittany Schaefer, CNP

  • Primary Care Nurse Practitioner
  • Dell Rapids, SD
  • NPI 1275362766
  NPD
• Salina A Neuman, DNP

  • Family Nurse Practitioner
  • Jackson, MN
  • NPI 1972081453
  NPD
• Jesse Nieuwenhuis

  • Family Medicine Physician
  • Hutchinson, MN
  • NPI 1215341250
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1104187343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86430",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186430",
            "telephone_number": "605-322-4900",
            "fax_number": "605-322-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086418",
            "telephone_number": "605-322-1530",
            "fax_number": "605-322-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-322-8000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group-Internal Medicine-Women's",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avera McKennan (Avera Neonatology Sioux Falls)
• Avera McKennan (Avera Medical Group Health Care Clinic Sioux Falls)
• Avera McKennan (Avera Medical Group Hospitalists Sioux Falls)
• Avera McKennan (Avera Medical Group Orthopedics and Sports Medicine)
• Avera McKennan (Avera Neurosurgery - Mark W. Fox, M.D., FACS)
• Avera McKennan (Avera Nephrology)
• Avera McKennan (Avera Medical Group Brain and Spine Institute)
• Avera McKennan
• Avera McKennan (Avera Medical Group Physical Medicine and Rehabilitation Sioux Falls)
• Avera McKennan (Avera Medical Group McGreevy 69th & Western)

• Internal Medicine Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Internal Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.