Avera McKennan

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

AVERA MCKENNAN

Doing business as

Avera Nephrology
Avera Nephrology Sioux Falls

Practice address

810 E 23Rd St Ste 403
Sioux Falls, SD 57105-2135

Phone

(605) 322-5800

Fax

(605) 322-5801

NPI assigned

Feb 23, 2006

Last updated

Mar 12, 2026By 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

Ronald J Place

Title

Ceo/President

Phone

(605) 322-7903

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 2

• Avera Nephrology Doing business as
• Avera Nephrology Sioux Falls Doing business as

Medicare fee-for-service enrollment

Enrolled in SD, MN, IA3 enrollments

Enrollment records 3

Other NPIs on the same Medicare enrollment 35

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Avera McKennan

  dba Avera Medical Group Urogynecology Sioux Falls

  • Obstetrics & Gynecology Physician
  • Sioux Falls, SD
  • NPI 1003188269

  O20040109001102

  Same enrollment
• Avera McKennan

  dba Avera Medical Group Rheumatology Sioux Falls

  • Rheumatology Physician
  • Sioux Falls, SD
  • NPI 1013177393

  O20040206000384

  Same enrollment
• Avera McKennan

  dba Avera Medical Group University Psychiatry Associates Sioux Falls

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1013980598

  O20040109001102, O20040206000384

  Same enrollment
• Avera McKennan

  dba Avera Medical Group Oncology and Hematology Sioux Falls

  • Hematology & Oncology Physician
  • Sioux Falls, SD
  • NPI 1033185582

  O20040109001102, O20040206000384

  Same enrollment
• Avera McKennan

  dba Avera Interventional Radiology

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678

  O20040109001102, O20040206000384

  Same enrollment
• Avera McKennan

  dba Avera Medical Group Orthopedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Sioux Falls, SD
  • NPI 1093262131

  O20040109001102, O20040206000384

  Same enrollment
• Avera McKennan

  dba Avera Medical Group Brain and Spine Institute

  • Neurological Surgery Physician
  • Sioux Falls, SD
  • NPI 1114113693

  O20040206000384

  Same enrollment
• Avera McKennan

  dba Avera Medical Group Physical Medicine and Rehabilitation Sioux Falls

  • Physical Medicine & Rehabilitation Physician
  • Sioux Falls, SD
  • NPI 1134195332

  O20040109001102, O20040206000384

  Same enrollment
• Avera McKennan

  dba Avera Medical Group McHale Institute

  • Hematology & Oncology Physician
  • Sioux Falls, SD
  • NPI 1164780201

  O20040109001102

  Same enrollment
• Avera McKennan

  dba Avera Maternal Fetal Medicine Sioux Falls

  • Maternal & Fetal Medicine Physician
  • Sioux Falls, SD
  • NPI 1205808748

  O20040109001102

  Same enrollment
• Avera McKennan

  dba Avera Medical Group Womens Health Specialists Sioux Falls

  • Obstetrics & Gynecology Physician
  • Sioux Falls, SD
  • NPI 1336111962

  O20040109001102, O20040206000384

  Same enrollment
• Avera McKennan

  dba Avera Dermatology

  • Dermatology Physician
  • Sioux Falls, SD
  • NPI 1346216074

  O20040109001102, O20040206000384

  Same enrollment

Locations

Practitioners 30

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.

• Carl Dustin Bechtold, M.D.

  • Orthopaedic Surgery Physician
  • Sioux Falls, SD
  • NPI 1336160589
  NPD
• Jeffrey Todd Domingue, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Sioux Falls, SD
  • NPI 1962418178
  NPD
• Sara T Granville, PA

  • Physician Assistant
  • Pierre, SD
  • NPI 1457670366
  NPD
• Cooper Buford Gross

  • Family Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1295219491
  NPD
• Sarah Heckel, CNP

  • Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1285177782
  NPD
• Lu Y Huber, MD

  • Nephrology Physician
  • Sioux Falls, SD
  • NPI 1629278759
  NPD
• Holly Ann Louise Jensen, DNP, ARNP

  • Family Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1154874204
  NPD
• Elizabeth Marie Kallsen, CNP

  • Family Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1437629987
  NPD
• Wyatt Knobloch

  • Family Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1043966914
  NPD
• Michael Allen Langston, PA-C

  • Physician Assistant
  • Sioux Falls, SD
  • NPI 1043242506
  NPD
• Travis Richard Liddell, M.D.

  • Orthopaedic Surgery Physician
  • Sioux Falls, SD
  • NPI 1144232042
  NPD
• Kevin Marquez, M.D.

  • Nephrology Physician
  • Sioux Falls, SD
  • NPI 1205179470
  NPD

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1104892892",
    "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": "810 E 23RD ST STE 403",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052135",
            "telephone_number": "605-322-5800",
            "fax_number": "605-322-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "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": "605-322-7903"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12903",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0550814",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PLUS",
            "identifier": "118T5NO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "031013001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "81741",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0008493",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "118T5NO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "370624200",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210830500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Nephrology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Nephrology Sioux Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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 Medical Group-Internal Medicine-Women's)
• 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)
• Avera McKennan (Avera Children's)

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

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.