NPIMap

Organization Active NPI

Avera McKennan

  • Hematology & Oncology Physician
  • Sioux Falls, SD
National Provider Identifier
1164780201
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
AVERA MCKENNAN
Practice address
3720 W 69TH St
Sioux Falls, SD 57108-8192
Phone
(605) 339-4464
Fax
(605) 339-0309
NPI assigned
Apr 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Julie N Norton
Title
Senior VP Finance
Phone
(605) 322-6375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

3720 W 69TH St
Sioux Falls, SD 57108-8192

Mailing address

2400 S Minnesota Ave
Ste 100
Sioux Falls, SD 57105-3761
Phone (605) 322-7510

Other names 1

  • Avera Medical Group McHale Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MN2 enrollments

Enrollment records 2

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
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…

Other NPIs on the same Medicare enrollment 21

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

View all 21

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1335398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1164780201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S MINNESOTA AVE",
            "address_2": "STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571053761",
            "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": "3720 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088192",
            "telephone_number": "605-339-4464",
            "fax_number": "605-339-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SENIOR VP FINANCE",
        "authorized_official_telephone_number": "605-322-6375"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group McHale Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 26, 2012; 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.