Avera McKennan

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

3344 Issued in SD

Legal business name

AVERA MCKENNAN

Doing business as

Avera Winner Medical Clinic

Practice address

1436 E 10TH St
Winner, SD 57580-2818

Phone

(605) 842-2443

Fax

(605) 842-1650

NPI assigned

Jun 16, 2006

Last updated

May 31, 2017By 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 Norton

Title

Cfo/SVP

Phone

(605) 322-7818

Specialties & licenses 1

Addresses

Other names 1

• Avera Winner Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496188800000",
    "number": "1851336887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 E 10TH ST",
            "address_2": "STE #2",
            "city": "WINNER",
            "state": "SD",
            "postal_code": "575802875",
            "telephone_number": "605-842-2443",
            "fax_number": "605-842-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 E 10TH ST",
            "city": "WINNER",
            "state": "SD",
            "postal_code": "575802818",
            "telephone_number": "605-842-2443",
            "fax_number": "605-842-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2017-05-31",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CFO/SVP",
        "authorized_official_telephone_number": "605-322-7818"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SD",
            "license": "3344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Winner Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Aasheim
• Edward Amoah Acheampong
• Joey Christian Anderson, NREMT
• Atlas Chiropractic of Winner, LLC
• Avera McKennan (Avera Medical Group Winner)
• Haley I Barfuss, B.S.
• Judy J. Bartels, R.N.
• Robyn Brazelton
• Donna Raye Brown, MS

• Clinic/Center in Winner, SD
• Providers in Winner, SD by specialty
• Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.