Active NPI
Avera McKennan
Doing business as Avera McKennan Hospital and University Health Center - Diabetic Ed
- General Acute Care Hospital
- Sioux Falls, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 10563
- Legal business name
- AVERA MCKENNAN
- Doing business as
- Avera McKennan Hospital and University Health Center - Diabetic Ed
- Practice address
- 1325 S Cliff Ave
Sioux Falls, SD 57105-1007 - Phone
- (605) 322-6404
- Fax
- (605) 322-6499
- NPI assigned
- May 23, 2007
- Last updated
- Oct 4, 2023
- 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 Joseph Place, MD
- Title
- President/Ceo
- Phone
- (605) 322-7903
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | NU | ||
| General Acute Care Hospital | 282N00000X | 10563 | SD | Primary |
Addresses
Primary practice location
1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Mailing address
PO Box 5045
Attn: P.F.S. Prov Enrollmt
Sioux Falls, SD 57117-5045
Phone (605) 322-6404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5590230 | Medicaid | SD |
Other names 1
- Avera McKennan Hospital and University Health Center - Diabetic Ed
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 1154531630. 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 22
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
O20040506000713
-
dba Avera Medical Group Rheumatology Sioux Falls
- Rheumatology Physician
- Sioux Falls, SD
- NPI 1013177393
O20040506000713
-
dba Avera Medical Group University Psychiatry Associates Sioux Falls
- Psychiatry Physician
- Sioux Falls, SD
- NPI 1013980598
O20040506000713
-
dba Avera Medical Group Orthopedics and Sports Medicine
- Orthopaedic Surgery Physician
- Sioux Falls, SD
- NPI 1093262131
O20040506000713
-
dba Avera Medical Group Brain and Spine Institute
- Neurological Surgery Physician
- Sioux Falls, SD
- NPI 1114113693
O20040506000713
-
dba Avera Medical Group Physical Medicine and Rehabilitation Sioux Falls
- Physical Medicine & Rehabilitation Physician
- Sioux Falls, SD
- NPI 1134195332
O20040506000713
-
dba Avera Gastroenterology Sioux Falls
- Gastroenterology Physician
- Sioux Falls, SD
- NPI 1194799882
O20040506000713
-
dba Avera Medical Group Womens Health Specialists Sioux Falls
- Obstetrics & Gynecology Physician
- Sioux Falls, SD
- NPI 1336111962
O20040506000713
-
dba Avera Medical Group
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1376575514
O20040506000713
-
dba Avera Endocrinology and Diabetes
- Endocrinology, Diabetes & Metabolism Physician
- Sioux Falls, SD
- NPI 1396711016
O20040506000713
-
dba Avera Liver Disease
- Hepatology Physician
- Sioux Falls, SD
- NPI 1396945267
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 Directory- Tax ID family
- Presentation Health Sys
Organizations with this tax ID in the same state 23
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Avera Medical Group Addiction Medicine
- Addiction Medicine (Psychiatry & Neurology) Physician
- Sioux Falls, SD
- NPI 1013668698
-
dba Avera Dialysis Mitchell
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Mitchell, SD
- NPI 1023413093
-
dba Avera Medical Group McGreevy 69th & Minnesota Pediatrics
- Pediatrics Physician
- Sioux Falls, SD
- NPI 1033405436
-
dba Avera Prince of Peace Assisted Living
- Assisted Living Facility
- Sioux Falls, SD
- NPI 1053556068
-
dba Avera Interventional Radiology
- Diagnostic Radiology Physician
- Sioux Falls, SD
- NPI 1053680678
-
dba Avera Medical Group Brookings
- Clinical Medical Laboratory
- Brookings, SD
- NPI 1063782373
-
dba Avera Medical Group Health Care Clinic Sioux Falls
- Internal Medicine Physician
- Sioux Falls, SD
- NPI 1083894067
-
dba Avera Children's
- Pediatric Hematology & Oncology Physician
- Sioux Falls, SD
- NPI 1144488537
-
dba Avera Medical Group 69th and Cliff
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1144635863
-
dba Avera Addiction Care Center
- Substance Abuse Rehabilitation Facility
- Sioux Falls, SD
- NPI 1154979805
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
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": "1179878400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696377600000",
"number": "1154531630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5045",
"address_2": "ATTN: P.F.S. PROV ENROLLMT",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175045",
"telephone_number": "605-322-6404",
"fax_number": "605-322-6499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 S CLIFF AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571051007",
"telephone_number": "605-322-6404",
"fax_number": "605-322-6499"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVERA MCKENNAN",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-23",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A",
"authorized_official_last_name": "PLACE",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "JOSEPH",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "605-322-7903",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "SD",
"license": "10563",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5590230",
"state": "SD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Avera McKennan Hospital and University Health Center - Diabetic Ed",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Avera McKennan Hospital and University Health Center - Diabetic Ed",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sioux Falls, SD
- 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)
- Avera McKennan (Avera Medical Group 69th and Cliff)
- Avera McKennan (Avera Addiction Care Center)
- Avera McKennan
- Avera McKennan (Avera McKennan Home Infusion)
- Avera McKennan (Avera Medical Group McHale Institute)
- Avera McKennan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.