Avera McKennan

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

AVERA MCKENNAN

Doing business as

Avera Long Term Care Pharmacy Aberdeen

Practice address

815 1St Ave SE Ste 202
Aberdeen, SD 57401-4602

Phone

(605) 725-4001

Fax

(605) 725-2349

NPI assigned

Mar 11, 2022

Last updated

Mar 11, 2022By 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

David William Flicek

Title

President/Ceo

Phone

(605) 322-7915

Specialties & licenses 1

Addresses

Other names 1

• Avera Long Term Care Pharmacy Aberdeen Doing business as

Medicare fee-for-service enrollment

Enrolled in SD2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 6

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

• Avera McKennan

  dba Avera on Louise Pharmacy

  • Pharmacy
  • Sioux Falls, SD
  • NPI 1205311628

  O20081124000161

  Same enrollment
• Avera McKennan

  dba Avera 7th Avenue Pharmacy

  • Community/Retail Pharmacy
  • Sioux Falls, SD
  • NPI 1316463219

  O20081124000161

  Same enrollment
• Avera McKennan

  dba Avera Specialty Pharmacy

  • Specialty Pharmacy
  • Sioux Falls, SD
  • NPI 1346266202

  O20081124000161

  Same enrollment
• Avera McKennan

  dba Avera Long Term Care Pharmacy

  • Long Term Care Pharmacy
  • Sioux Falls, SD
  • NPI 1669871000

  O20081124000161

  Same enrollment
• Avera McKennan

  dba Avera Plaza 2 Pharmacy

  • Pharmacy
  • Sioux Falls, SD
  • NPI 1861110876

  O20081124000161

  Same enrollment
• Avera McKennan

  dba Avera 69th Street Pharmacy

  • Pharmacy
  • Sioux Falls, SD
  • NPI 1962787440

  O20081124000161

  Same enrollment

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

Medicare medical equipment & supply locations

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.

• Avera Gregory

  • Critical Access Hospital
  • Gregory, SD
  • NPI 1770939530
  NPD tax ID
• Avera McKennan

  dba Avera Dialysis Sioux Falls

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sioux Falls, SD
  • NPI 1710316252
  NPD tax ID
• Avera McKennan

  dba Avera McKennan Hospital Neonatal Intensive Care Unit

  • General Acute Care Hospital
  • Sioux Falls, SD
  • NPI 1730390428
  NPD tax ID
• Avera McKennan

  dba Avera Medical Group Behavioral Health Clinic

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1760933261
  NPD tax ID
• Avera McKennan

  dba Avera Medical Group Wilmot

  • Rural Health Clinic/Center
  • Wilmot, SD
  • NPI 1770680787
  NPD tax ID
• Avera McKennan

  dba Avera Flandreau Hospital Swingbed

  • Medicare Defined Swing Bed Hospital Unit
  • Flandreau, SD
  • NPI 1770690398
  NPD tax ID
• Avera McKennan

  dba Avera McKennan Renal Transplant Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sioux Falls, SD
  • NPI 1770753246
  NPD tax ID
• Avera McKennan

  • Home Health Agency
  • Marion, SD
  • NPI 1780887604
  NPD tax ID
• Avera McKennan

  dba Avera Medical Group Family Wellness

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1821478249
  NPD tax ID
• Avera McKennan

  dba Avera Medical Group Pediatric Critical Care Services

  • Pediatric Critical Care Medicine Physician
  • Sioux Falls, SD
  • NPI 1821686932
  NPD tax ID
• Avera McKennan

  dba Avera Tea Medical Clinic

  • Nurse Practitioner
  • Tea, SD
  • NPI 1831230408
  NPD tax ID
• Avera McKennan

  dba Avera Rehabilitation Associates

  • Physical Medicine & Rehabilitation Physician
  • Sioux Falls, SD
  • NPI 1841427770
  NPD tax ID

Member of 2

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

• Avera Home Medical Equipment, LLC

  • Durable Medical Equipment & Medical Supplies
  • Pierre, SD
  • NPI 1669548616

  Member Of

  NPD member
• Avera Home Medical Equipment, LLC

  • Durable Medical Equipment & Medical Supplies
  • Sioux Falls, SD
  • NPI 1902972334

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 9

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

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1841948643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 1ST AVE SE STE 202",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014602",
            "telephone_number": "605-725-4001",
            "fax_number": "605-725-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 1ST AVE SE STE 202",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014602",
            "telephone_number": "605-725-4001",
            "fax_number": "605-725-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "FLICEK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-322-7915"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Long Term Care Pharmacy Aberdeen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deptmer Martin Ashley, M.D.
• Kevin James Aston, DO
• Avera at Home (Avera@Home)
• Avera at Home (Avera@Home)
• Avera Home Medical Equipment, LLC
• Avera St Luke's (Avera Nano Nagle Village)
• Avera St Luke's (Avera St Lukes Hospital)
• Avera St Luke's (Avera St Lukes Therapy Group)
• Avera St Luke's
• Avera St Luke's (Avera Interventional Radiology Aberdeen)

• Long Term Care Pharmacy in Aberdeen, SD
• Providers in Aberdeen, SD by specialty
• Long Term Care Pharmacy in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.
• 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.