NPIMap

Organization Active NPI

Avera McKennan

  • Multi-Specialty Clinic/Center
  • Sioux Falls, SD
National Provider Identifier
1114246576
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
10563 Issued in SD
Legal business name
AVERA MCKENNAN
Practice address
1200 S 7TH Ave
Suite 2
Sioux Falls, SD 57105-0900
Phone
(605) 782-8307
Fax
(605) 782-8322
NPI assigned
May 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Authorized official

Name
Julie N Norton
Title
VP/Cfo
Phone
(605) 322-6375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 10563 SD Primary

Addresses

Primary practice location

1200 S 7TH Ave
Suite 2
Sioux Falls, SD 57105-0900

Mailing address

PO Box 5045
Attn: Provider Enrollment
Sioux Falls, SD 57117-5045
Phone (605) 322-6400

Other names 1

  • Avera McKennan Outpatient Therapy McGreevy Main Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Locations

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

1601 W 44th Pl
Sioux Falls, SD 57105
Phone (605) 201-6671

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1114246576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5045",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175045",
            "telephone_number": "605-322-6400",
            "fax_number": "605-322-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S 7TH AVE",
            "address_2": "SUITE 2",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050900",
            "telephone_number": "605-782-8307",
            "fax_number": "605-782-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "605-322-6375"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "SD",
            "license": "10563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera McKennan Outpatient Therapy McGreevy Main",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.