Avera McKennan

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AVERA MCKENNAN

Doing business as

Avera Medical Group Harrisburg

Practice address

220 S Cliff Ave Ste 120
Harrisburg, SD 57032-2117

Phone

(605) 213-8000

Fax

(605) 213-8005

NPI assigned

Feb 23, 2006

Last updated

May 16, 2012By 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 N Norton

Title

Sr Vice President of Finance

Phone

(605) 322-6375

Specialties & licenses 1

Addresses

Other names 1

• Avera Medical Group Harrisburg Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Avera Home Medical Equipment, LLC

  • Durable Medical Equipment & Medical Supplies
  • Pierre, SD
  • NPI 1669548616

  Member Of

  NPD member
• Avera Home Medical Equipment LLC

  • Durable Medical Equipment & Medical Supplies
  • Marshall, MN
  • NPI 1790793933

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1184690943",
    "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": "220 S CLIFF AVE STE 120",
            "city": "HARRISBURG",
            "state": "SD",
            "postal_code": "570322117",
            "telephone_number": "605-213-8000",
            "fax_number": "605-213-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SR VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "605-322-6375"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Harrisburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 605 Dietitian, LLC
• David A Basel, MD
• John D Boer, O.D.
• Eliana Zuniga Cerda
• Cherished Journeys Doula Services LLC
• Lora J Clark, MS, ATC

• Clinic/Center in Harrisburg, SD
• Providers in Harrisburg, SD by specialty
• Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.