Organization Active NPI

Avera McKennan

Doing business as Avera Medical Group

  • Family Medicine Physician
  • Sioux Falls, SD
National Provider Identifier
1376575514
Registry record updated Dec 22, 2025
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
Avera Medical Group McGreevy 7th Avenue
Practice address
1200 S 7TH Ave
Sioux Falls, SD 57105-0912
Phone
(605) 336-2140
NPI assigned
Jul 7, 2006
Last updated
Dec 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

1200 S 7TH Ave
Sioux Falls, SD 57105-0912

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
0716829MedicaidIA
996421500MedicaidMN

Other names 2

  • Avera Medical Group Doing business as
  • Avera Medical Group McGreevy 7th Avenue Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD3 enrollments

Enrollment records 3

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
O20040506000713 SD Part A Provider - Hospital 0345157103 22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20100930007605 SD DME Supplier - Physician - Osteopathic Manipulative Medicine 0345157103 Practice locations: Sioux Falls, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376575514. Details of each certification follow.

Hospital certification: CCN 430016

Legal name
AVERA MCKENNAN
Doing business as
AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 3, 2011
Beds
505
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 23, 1925 in SD
Enrollment address
1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 22

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

View all 22

Care Compare: Hospital

Medicare Care Compare
Listed as
Avera McKennan Hospital & University Health CenterCCN 430016 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D0407176Avera Medical Group McGreevy1200 South 7TH Ave, Sioux Falls, SD 57105AccreditationJun 23, 2028
43D1043896Avera Medical Group McGreevy 7TH Avenue1200 S 7TH Avenue, Sioux Falls, SD 57105Certificate of waiverAug 4, 2027

National Provider Directory

National Provider Directory

Member of 2

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

Locations

1101 E Holly Blvd
Brandon, SD 57005
Phone (605) 582-3853

1200 S 7th Ave
Sioux Falls, SD 57105
Phone (605) 336-2140

1910 W 69th St
Sioux Falls, SD 57108
Phone (605) 322-5200

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Alisa L Reindl Individual Corporate DirectorBoard Member Jul 1, 2021
James Francis Dover Individual Corporate OfficerFache, President/Ceo Avera Health Oct 23, 2023
Tamera L Sturm Individual Corporate DirectorBoard Member Jul 1, 2025
Van Fishback Individual Corporate DirectorBoard Member Jul 1, 2018
Candyce C Chrystal Individual Corporate DirectorBoard Member Jul 1, 2024
Harriet Yocum Individual Corporate DirectorBoard Member Jul 1, 2021
Jennifer Bunkers Individual Corporate DirectorBoard Member Jul 1, 2021
Randy Knecht Individual Corporate DirectorBoard Member Jul 1, 2018
Jawad Nazir Individual Corporate DirectorBoard Member Jul 1, 2020
Lucille F Welbig Individual Corporate DirectorBoard Member Jul 1, 2015
Joseph Patrick Costello Individual Corporate DirectorBoard Member Jul 1, 2017
Sanaa Abourezk Individual Corporate DirectorBoard Member Jul 1, 2024
Amanda Marie Schutz Individual Contracted Managing Employee Jun 15, 2018
Ryan Boschee Individual Corporate DirectorBoard Member Jul 1, 2024
Jennifer Kirby Individual Corporate DirectorBoard Member Jul 1, 2020
Ronald J. Place Individual Corporate OfficerPresident/Ceo Jun 5, 2023
Operational/Managerial Control Jun 5, 2023
Julie Lautt Individual Corporate OfficerCfo Mar 1, 2020
Mary C Curran Individual Corporate DirectorBoard Member Jul 1, 2017
Avera Health Organization, Sioux Falls, SD Corporation, Chain home office 5% Or Greater Direct Ownership Interest Jul 1, 2000
Operational/Managerial Control Jul 1, 2000
Roxanne P Seifert Individual Corporate DirectorBoard Member Jul 1, 2024
Cristina a Hill Jensen Individual Corporate DirectorBoard Member Jul 1, 2018
Benjamin M Solomon Individual Corporate DirectorBoard Member Jul 1, 2022

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lakes Regional HealthcareSpirit Lake, IA, CCN 160124 Hospital Operational/Managerial Control Oct 24, 2022
Avera Heart Hospital of South DakotaSioux Falls, SD, CCN 430095 Hospital 5% Or Greater Direct Ownership Interest (33.33%) Oct 1, 2010
Avera Holy Family HospitalEstherville, IA, CCN 161351 Hospital Operational/Managerial Control Oct 6, 1994
Avera Holy Family HospitalEstherville, IA, CCN 16Z351 Hospital Operational/Managerial Control Jan 1, 2007
Lakes Regional HealthcareSpirit Lake, IA, CCN 16U124 Hospital Operational/Managerial Control Oct 24, 2022
United Living CommunityBrookings, SD, CCN 435079 Skilled nursing facility Operational/Managerial Control Nov 15, 2005
Freeman Regional Health ServicesMenno, SD, CCN 433444 Rural health clinic 5% Or Greater Direct Ownership Interest (50%) May 1, 2011
Freeman Regional Health ServicesBridgewater, SD, CCN 433443 Rural health clinic 5% Or Greater Direct Ownership Interest (50%) May 1, 2011
Freeman Regional Health ServicesMarion, SD, CCN 433445 Rural health clinic 5% Or Greater Direct Ownership Interest (50%) May 1, 2011

Practitioners & affiliated clinicians

Practitioners 509

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 509

Affiliated clinicians 1,295

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,295

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1376575514",
    "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": "1200 S 7TH AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050912",
            "telephone_number": "605-336-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "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": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0716829",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "996421500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Medical Group McGreevy 7th Avenue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.