Avera McKennan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

AVERA MCKENNAN

Doing business as

Avera Medical Group Big Stone City

Practice address

451 Main St
Big Stone City, SD 57216

Phone

(605) 862-7999

Fax

(605) 862-7998

NPI assigned

Sep 28, 2006

Last updated

Mar 16, 2011By 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

Cfo

Phone

(605) 322-6375

Specialties & licenses 1

Addresses

Other names 1

• AVERA MEDICAL GROUP BIG STONE CITY 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

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1497847446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 MAIN ST",
            "address_2": "PO BOX 145",
            "city": "BIG STONE CITY",
            "state": "SD",
            "postal_code": "57216",
            "telephone_number": "605-862-7999",
            "fax_number": "605-862-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 MAIN ST",
            "city": "BIG STONE CITY",
            "state": "SD",
            "postal_code": "57216",
            "telephone_number": "605-862-7999",
            "fax_number": "605-862-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-322-6375"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVERA MEDICAL GROUP BIG STONE CITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Corey Gordon Abbas, PT
• Sara Adelman, OTA
• Michele Anderson
• John M Bates
• Hanna Becker, SLP
• Jenna Behnken, PT
• Big Stone Therapies, Inc
• Trista Bjerk, SLP

• Physician Assistant in Big Stone City, SD
• Providers in Big Stone City, SD by specialty
• Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.