Active NPI
Avera Gregory
- Critical Access Hospital
- Gregory, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- License
- 1767
- Legal business name
- AVERA GREGORY
- Practice address
- 400 Park Ave
Gregory, SD 57533-1302 - Phone
- (605) 835-5190
- Fax
- (605) 835-5479
- NPI assigned
- May 11, 2016
- Last updated
- May 11, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. McKenzie Marie Randall, DPT, PT, ATC
- Title
- Physical Therapist
- Phone
- (605) 835-5190
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 1767 | SD | Primary |
Addresses
Primary practice location
400 Park Ave
Gregory, SD 57533-1302
Mailing address
400 Park Ave
Gregory, SD 57533-1302
Phone (605) 835-5190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1770939530. Details of each certification follow.
Hospital certification: CCN 430047
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- AVERA GREGORY HEALTHCARE CENTER
- Certification status
- Terminated Voluntary: merger or closure, Dec 21, 2005
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- May 13, 2004
- Beds
- 26
- Ownership / control type
- Other
- Most recent change of ownership
- May 1, 2002 (1 total)
- Facility address
- 400 Park Avenue, Post Office Box 408
Gregory, SD 57533
National Provider Directory
National Provider Directory- Tax ID family
- Amg Radiology
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.
-
dba Avera Medical Group Flandreau
- Family Medicine Physician
- Flandreau, SD
- NPI 1679140396
-
dba Avera Medical Group McGreevy Whittier
- Family Medicine Physician
- Sioux Falls, SD
- NPI 1699005074
-
- Addiction (Substance Use Disorder) Counselor
- Sioux Falls, SD
- NPI 1699979724
-
dba AMG Occupational Medicine Sioux Falls
- Occupational Medicine Physician
- Sioux Falls, SD
- NPI 1700905650
-
dba Avera Dells Area Hospital Swingbed
- Medicare Defined Swing Bed Hospital Unit
- Dell Rapids, SD
- NPI 1710089172
-
dba Avera Dialysis Sioux Falls
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Sioux Falls, SD
- NPI 1710316252
-
dba Avera McKennan Hospital Neonatal Intensive Care Unit
- General Acute Care Hospital
- Sioux Falls, SD
- NPI 1730390428
-
dba Avera Medical Group Behavioral Health Clinic
- Psychiatry Physician
- Sioux Falls, SD
- NPI 1760933261
-
dba Avera Flandreau Hospital Swingbed
- Medicare Defined Swing Bed Hospital Unit
- Flandreau, SD
- NPI 1770690398
-
dba Avera McKennan Renal Transplant Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Sioux Falls, SD
- NPI 1770753246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462924800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1462924800000",
"number": "1770939530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 PARK AVE",
"city": "GREGORY",
"state": "SD",
"postal_code": "575331302",
"telephone_number": "605-835-5190",
"fax_number": "605-835-5479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 PARK AVE",
"city": "GREGORY",
"state": "SD",
"postal_code": "575331302",
"telephone_number": "605-835-5190",
"fax_number": "605-835-5479"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVERA GREGORY",
"organizational_subpart": "NO",
"enumeration_date": "2016-05-11",
"last_updated": "2016-05-11",
"status": "A",
"authorized_official_last_name": "RANDALL",
"authorized_official_first_name": "MCKENZIE",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "PHYSICAL THERAPIST",
"authorized_official_telephone_number": "605-835-5190",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "DPT, PT, ATC"
},
"taxonomies": [
{
"code": "282NC0060X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Critical Access",
"state": "SD",
"license": "1767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gregory, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.