Active NPI
Avera McKennan
Doing business as Avera Medical Group Fairfax
- Clinic/Center
- Fairfax, SD
National Provider Identifier
1215967203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- AVERA MCKENNAN
- Doing business as
- Avera Medical Group Fairfax
- Practice address
- 421 Main St
Fairfax, SD 57335-0354 - Phone
- (605) 654-2366
- NPI assigned
- Jul 4, 2006
- Last updated
- Mar 21, 2011
- 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
- Julie N Norton
- Title
- Vice President of Finance
- Phone
- (605) 322-6375
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | NU | Primary |
Addresses
Primary practice location
421 Main St
Fairfax, SD 57335-0354
Mailing address
PO Box 354
421 Main
Fairfax, SD 57335-0354
Phone (605) 654-2366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000028 | Other | SD | WELLMARK BC/BS |
Other names 1
- Avera Medical Group Fairfax
National Provider Directory
National Provider Directory- Tax ID family
- Presentation Health Sys
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
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 McKennan Hospital and University Health Center - Diabetic Ed
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1154531630
-
dba Avera Addiction Care Center
- Substance Abuse Rehabilitation Facility
- Sioux Falls, SD
- NPI 1154979805
-
- Psychiatric Hospital Unit
- Sioux Falls, SD
- NPI 1164445250
-
dba Avera Medical Group Garretson
- Family Medicine Physician
- Garretson, SD
- NPI 1174671242
-
dba Avera McKennan Hospital and University Health Center - Rehab Unit
- Rehabilitation Hospital Unit
- Sioux Falls, SD
- NPI 1215951629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1300665600000",
"number": "1215967203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 354",
"address_2": "421 MAIN",
"city": "FAIRFAX",
"state": "SD",
"postal_code": "573350354",
"telephone_number": "605-654-2366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 MAIN ST",
"city": "FAIRFAX",
"state": "SD",
"postal_code": "573350354",
"telephone_number": "605-654-2366"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVERA MCKENNAN",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-04",
"last_updated": "2011-03-21",
"status": "A",
"authorized_official_last_name": "NORTON",
"authorized_official_first_name": "JULIE",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
"authorized_official_telephone_number": "605-322-6375"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BC/BS",
"identifier": "0000028",
"state": "SD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Avera Medical Group Fairfax",
"code": "3",
"type": "Doing Business As"
}
]
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.