NPIMap

Organization Active NPI

Avera McKennan

Doing business as Avera Plaza 2 Pharmacy

  • Pharmacy
  • Sioux Falls, SD
National Provider Identifier
1861110876
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
AVERA MCKENNAN
Doing business as
Avera Plaza 2 Pharmacy
Practice address
1301 S Cliff Ave Ste 225
Sioux Falls, SD 57105-1068
Phone
(605) 504-0491
Fax
(605) 504-0492
NPI assigned
Aug 16, 2022
Last updated
Aug 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ronald Joseph Place
Title
President/Ceo
Phone
(605) 322-7903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

1301 S Cliff Ave Ste 225
Sioux Falls, SD 57105-1068

Mailing address

911 E 20TH St Ste 500
Sioux Falls, SD 57105-1047
Phone (605) 322-8493

Other names 1

  • Avera Plaza 2 Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081124000161 SD Part B Supplier - Mass Immunization (Roster Biller Only) 0345157103 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, SD; Sioux Falls, SD
O20230517002249 SD DME Supplier - Pharmacy 0345157103 Practice locations: Sioux Falls, SD

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Amg Radiology105 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 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
  • Avera McKennan

    dba Avera Long Term Care Pharmacy Aberdeen

    • Long Term Care Pharmacy
    • Aberdeen, SD
    • NPI 1841948643
    NPD tax ID
View all 24

Member of 2

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

Locations

1301 S Cliff Ave
Ste 225
Sioux Falls, SD 57105
Phone (605) 322-8493

Ownership & related parties

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

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1861110876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 E 20TH ST STE 500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051047",
            "telephone_number": "605-322-8493",
            "fax_number": "605-322-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE STE 225",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051068",
            "telephone_number": "605-504-0491",
            "fax_number": "605-504-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "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"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Plaza 2 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera Plaza 2 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.