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Organization Active NPI

Avera McKennan

Doing business as Avera Therapy

  • Physical Therapist
  • Sioux Falls, SD
National Provider Identifier
1629499132
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
AVERA MCKENNAN
Doing business as
Avera Therapy
Practice address
6100 S Louise Ave Ste 1275
Sioux Falls, SD 57108-6029
Phone
(605) 322-8000
NPI assigned
Dec 31, 2013
Last updated
Nov 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ronald Joseph Place, MD
Title
President/Ceo
Phone
(605) 322-7903

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Prosthetic/Orthotic Supplier 335E00000X NU
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

6100 S Louise Ave Ste 1275
Sioux Falls, SD 57108-6029

Mailing address

PO Box 5045
Attn: P.F.S. Prov Enrollmt
Sioux Falls, SD 57117-5045
Phone (605) 322-3278

Other practice location 1

2100 S Marion Rd Ste 100
Sioux Falls, SD 57106-3647
Phone (605) 322-8000

Other practice location 2

103 N Splitrock Blvd
Brandon, SD 57005-1529
Phone (605) 322-8000

Other practice location 3

810 E 23rd St Ste 2100
Sioux Falls, SD 57105-2132
Phone (605) 322-8000

Other practice location 4

6800 S Louise Ave
Sioux Falls, SD 57108-6026
Phone (605) 322-8000

Other practice location 5

3400 S Southeastern Ave
Sioux Falls, SD 57103-7184
Phone (605) 322-8000

Other names 1

  • Avera Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

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
O20241226000998 SD DME Supplier - Orthotic Personnel 0345157103 Practice locations: Sioux Falls, SD

National Provider Directory

National Provider Directory
Tax ID family
Presentation Health Sys105 organizations share this tax ID, including this one

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.

View all 24

Member of 2

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

Locations

1601 W 44th Pl
Sioux Falls, SD 57105
Phone (605) 201-6671

2100 S Marion Rd
Ste 100
Sioux Falls, SD 57106
Phone (605) 322-5156

Ownership & related parties

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 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1629499132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5045",
            "address_2": "ATTN: P.F.S. PROV ENROLLMT",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175045",
            "telephone_number": "605-322-3278",
            "fax_number": "605-322-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 S LOUISE AVE STE 1275",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086029",
            "telephone_number": "605-322-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 S Marion Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571063647",
            "country_code": "US",
            "telephone_number": "605-322-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 N Splitrock Blvd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "SD",
            "postal_code": "570051529",
            "country_code": "US",
            "telephone_number": "605-322-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 E 23rd St Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571052132",
            "country_code": "US",
            "telephone_number": "605-322-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6800 S Louise Ave",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571086026",
            "country_code": "US",
            "telephone_number": "605-322-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 S Southeastern Ave",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571037184",
            "country_code": "US",
            "telephone_number": "605-322-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-31",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "PLACE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-322-7903",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.