Avera McKennan

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AVERA MCKENNAN

Doing business as

Avera Medical Group Family Health Center

Practice address

2100 S. Marion Rd.
Sioux Falls, SD 57106-3646

Phone

(605) 322-1010

Fax

(605) 322-1011

NPI assigned

Nov 29, 2006

Last updated

Oct 20, 2016By 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 N Norton

Title

Sr Vice President of Financre

Phone

(605) 322-6375

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Avera Medical Group Family Health Center Doing business as

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

CLIA laboratory certificates

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
  • Parkston, SD
  • NPI 1568530566

  Member Of

  NPD member
• Avera Home Medical Equipment, LLC

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

  Member Of

  NPD member

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1851468532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86430",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186430",
            "telephone_number": "605-322-4900",
            "fax_number": "605-322-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S. MARION RD.",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571063646",
            "telephone_number": "605-322-1010",
            "fax_number": "605-322-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SR VICE PRESIDENT OF FINANCRE",
        "authorized_official_telephone_number": "605-322-6375"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0716829",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avera McKennan (Avera Internal Medicine)
• Avera McKennan (Avera McKennan Renal Transplant Center)
• Avera McKennan (Avera Medical Group Family Wellness)
• Avera McKennan (Avera Medical Group Pediatric Critical Care Services)
• Avera McKennan (Avera Rehabilitation Associates)
• Avera McKennan (Avera Medical Group Optometry)
• Avera McKennan (Avera Plaza 2 Pharmacy)
• Avera McKennan (Avera McKennan Hospital and University Health Center - Placement)
• Avera McKennan (Avera McKennan Regional Lab)
• Avera McKennan (Avera Community Health Resource Program)

• Family Medicine Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.