NPIMap

Organization Active NPI

Avera McKennan

Doing business as Avera Medical Group Milbank

  • Rural Health Clinic/Center
  • Milbank, SD
National Provider Identifier
1750488730
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
AVERA MCKENNAN
Doing business as
Avera Medical Group Milbank
Practice address
301 Flynn Dr
Milbank, SD 57252-1508
Phone
(605) 432-4587
NPI assigned
Sep 20, 2006
Last updated
Mar 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

301 Flynn Dr
Milbank, SD 57252-1508

Mailing address

PO Box 5045
Cbo Prov Enrlmt
Sioux Falls, SD 57117-5045
Phone (605) 322-6428

Other identifiers 3

IdentifierTypeStateIssuer
148019700OtherMN MEDICAID
10148OtherSDMEDICAID SD
43D0407375OtherCLIA

Other names 1

  • Avera Medical Group Milbank Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MN4 enrollments

Enrollment records 4

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
O20040109001102 MN Part B Supplier - Clinic/Group Practice 0345157103 Receives reassigned benefits from 81 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Worthington, MN; Windom, MN; Tyler, MN; Slayton, MN; Pipestone, MN; Lakefield, MN; Ortonville, MN; Marshall, MN…
O20061104000081 SD Part A Provider - Critical Access Hospital 0345157103 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Milbank, SD
O20091214000790 SD Part A Provider - Rural Health Clinic 0345157103 Practice locations: Milbank, SD

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1750488730. Details of each certification follow.

Hospital certification: CCN 431326

Legal name
AVERA MCKENNAN
Doing business as
MILBANK AREA HOSPITAL/AVERA HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2002
Last certification
Dec 31, 2025
Beds
25
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jul 1, 2002 (1 total)
Organization structure
CorporationNon-profit
Incorporated
May 23, 1925 in SD
Enrollment address
301 Flynn Dr
Milbank, SD 57252-1502
Main/Primary Hospital Location

Rural health clinic certification: CCN 433435

Legal name
AVERA MCKENNAN
Doing business as
AVERA MEDICAL GROUP MILBANK
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 30, 2011
Last certification
Jan 22, 2026
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 25, 1923 in SD
Enrollment address
301 Flynn Dr
Milbank, SD 57252-1508
Related CCNs
431326

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.

  • Avera McKennan

    dba Avera Medical Group Urogynecology Sioux Falls

    • Obstetrics & Gynecology Physician
    • Sioux Falls, SD
    • NPI 1003188269

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Medical Group University Psychiatry Associates Sioux Falls

    • Psychiatry Physician
    • Sioux Falls, SD
    • NPI 1013980598

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Medical Group Oncology and Hematology Sioux Falls

    • Hematology & Oncology Physician
    • Sioux Falls, SD
    • NPI 1033185582

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Medical Group Orthopedics and Sports Medicine

    • Orthopaedic Surgery Physician
    • Sioux Falls, SD
    • NPI 1093262131

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Nephrology

    • Nephrology Physician
    • Sioux Falls, SD
    • NPI 1104892892

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Medical Group Physical Medicine and Rehabilitation Sioux Falls

    • Physical Medicine & Rehabilitation Physician
    • Sioux Falls, SD
    • NPI 1134195332

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Medical Group McHale Institute

    • Hematology & Oncology Physician
    • Sioux Falls, SD
    • NPI 1164780201

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Maternal Fetal Medicine Sioux Falls

    • Maternal & Fetal Medicine Physician
    • Sioux Falls, SD
    • NPI 1205808748

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Medical Group Womens Health Specialists Sioux Falls

    • Obstetrics & Gynecology Physician
    • Sioux Falls, SD
    • NPI 1336111962

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Dermatology

    • Dermatology Physician
    • Sioux Falls, SD
    • NPI 1346216074

    O20040109001102

    Same enrollment
  • Avera McKennan

    dba Avera Medical Group Pulmonary and Sleep Medicine Sioux Falls

    • Pulmonary Disease Physician
    • Sioux Falls, SD
    • NPI 1386610004

    O20040109001102

    Same enrollment
View all 22

Care Compare: Hospital

Medicare Care Compare
Listed as
Milbank Area Hospital/Avera HealthCCN 431326 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 28

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
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, 2023
Natalie Gauer Individual W-2 Managing Employee Jan 1, 1997
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, 2016
Joseph Patrick Costello Individual Corporate DirectorBoard Member Jul 1, 2017
Sanaa Abourezk Individual Corporate DirectorBoard Member Jul 1, 2024
Ryan Boschee Individual Corporate DirectorBoard Member Jul 1, 2025
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 Jul 1, 2009
Corporate OfficerCfo Mar 1, 2020
Mary C Curran Individual Corporate DirectorBoard Member Jul 1, 2017
Corporate DirectorBoard Member Jul 1, 2018
Avera Health Organization, Sioux Falls, SD Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2000
Operational/Managerial Control Jul 1, 2000
5% Or Greater Direct Ownership Interest Jul 1, 2009 100%
Operational/Managerial Control Jul 1, 2009
Roxanne P Seifert Individual Corporate DirectorBoard Member Jul 1, 2022
Cristina a Hill Jensen Individual Corporate DirectorBoard Member Jul 1, 2018
Benjamin M Solomon Individual Corporate DirectorBoard Member Jul 1, 2022
James Francis Dover Individual Corporate OfficerPresident/Ceo Avera Health Oct 23, 2023
Patti Swenson Individual W-2 Managing Employee Jul 1, 2013
Joseph Thomas Biegler Individual Corporate DirectorBoard Member Jul 1, 2016
Laurie Knutson Individual Corporate DirectorBoard Member Jul 1, 2017
Brenda K Kallemeyn Individual Corporate DirectorBoard Member Jul 1, 2023
Alejandro Ramirez Individual Corporate DirectorBoard Member Jul 1, 2016
Jeffrey Gordon Individual Corporate DirectorBoard Member Jul 1, 2023

Owners & managing parties with NPI records 6

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

Facilities with the same owner 90

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 90

Practitioners & affiliated clinicians

Practitioners 10

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.

Affiliated clinicians 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1750488730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5045",
            "address_2": "CBO PROV ENRLMT",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175045",
            "telephone_number": "605-322-6428",
            "fax_number": "605-432-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FLYNN DR",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572521508",
            "telephone_number": "605-432-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICAID",
            "identifier": "148019700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID SD",
            "identifier": "10148",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "43D0407375",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Milbank",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Medical Group Milbank",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milbank, SD

Sources for this page

Verify at the official NPI Registry.