NPIMap

Organization Active NPI

Avera McKennan

Doing business as Avera Medical Group McGreevy Southeastern Avenue

  • Family Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1255408944
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AVERA MCKENNAN
Doing business as
Avera Medical Group McGreevy Southeastern Avenue
Practice address
3400 S Southeastern Ave
Sioux Falls, SD 57103-7184
Phone
(605) 371-1866
Fax
(605) 371-0918
NPI assigned
Nov 29, 2006
Last updated
May 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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 Fiance
Phone
(605) 322-6375

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

3400 S Southeastern Ave
Sioux Falls, SD 57103-7184

Mailing address

PO Box 86430
Sioux Falls, SD 57118-6430
Phone (605) 322-4900

Other names 1

  • Avera Medical Group McGreevy Southeastern Avenue Doing business as

National Provider Directory

National Provider Directory

Member of 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1255408944",
    "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": "605-322-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S SOUTHEASTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571037184",
            "telephone_number": "605-371-1866",
            "fax_number": "605-371-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-05-10",
        "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 FIANCE",
        "authorized_official_telephone_number": "605-322-6375"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group McGreevy Southeastern Avenue",
            "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 May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.