Avera McKennan

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AVERA MCKENNAN

Doing business as

Avera Medical Group McGreevy Brandon

Practice address

1101 E Holly Blvd
Brandon, SD 57005-1426

Phone

(605) 582-3853

Fax

(605) 582-3855

NPI assigned

Nov 29, 2006

Last updated

May 10, 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) 322-7818

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Avera Medical Group McGreevy Brandon Doing business as

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
  • Parkston, SD
  • NPI 1568530566

  Member Of

  NPD member
• Avera Home Medical Equipment, LLC

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

  Member Of

  NPD member

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": "1285701870",
    "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": "1101 E HOLLY BLVD",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570051426",
            "telephone_number": "605-582-3853",
            "fax_number": "605-582-3855"
        }
    ],
    "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 FINANCE",
        "authorized_official_telephone_number": "605-322-7818"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0716829",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group McGreevy Brandon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Agape Counseling Center LLC
• Macy Archer, MA, CCC-SLP
• Ascend Counseling, LLC
• Aspire Counseling & Consulting, LLC
• Authentic Counseling LLC
• Avera McKennan (Avera McKennan Outpatient Therapy Services - Brandon)
• Kara Lynn Baas, LPC-MH
• Kyle Babb
• Jessica Ann Bebensee, PHARMD
• Bethany Lutheran Home

• Family Medicine Physician in Brandon, SD
• Providers in Brandon, SD by specialty
• Family Medicine Physician in South Dakota

• 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.
• 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.