Avera McKennan

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

AVERA MCKENNAN

Practice address

660 W 2ND St
Winner, SD 57580-1218

Phone

(605) 842-2443

Fax

(605) 842-1650

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Julie Norton

Title

Controller

Phone

(605) 322-6375

Specialties & licenses 1

Addresses

Other names 1

• Avera Medical Group Winner Doing business as

Medicare fee-for-service enrollment

Enrolled in SD2 enrollments

Enrollment records 2

Rural health clinic certification: CCN 433447

Legal name

AVERA MCKENNAN

Doing business as

AVERA MEDICAL GROUP WINNER

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Mar 21, 2017

Last certification

Mar 21, 2017

Ownership / control type

2B

Organization structure

CorporationNon-profit

Incorporated

Sep 1, 2000 in SD

Enrollment address

660 W 2ND St
Winner, SD 57580-1218

Related CCNs

431338

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Avera McKennan

  • Critical Access Hospital
  • Gregory, SD
  • NPI 1275562027

  Parent provider

  Provider of Services

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Cristina Alison Hill Jensen, M.D.

  • Gastroenterology Physician
  • Sioux Falls, SD
  • NPI 1760691794

  Corporate Director

  CMS ownership
• Brenda Kay Kallemeyn, MD

  • Obstetrics & Gynecology Physician
  • Sioux Falls, SD
  • NPI 1144237280

  Corporate Director

  CMS ownership
• Jawad Nazir, MD

  • Infectious Disease Physician
  • Sioux Falls, SD
  • NPI 1972579118

  Corporate Director

  CMS ownership
• Alisa L Reindl, MD

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1912149899

  Corporate Director

  CMS ownership
• Benjamin Maurice Solomon, MD

  • Hematology & Oncology Physician
  • Sioux Falls, SD
  • NPI 1912107368

  Corporate Director

  CMS ownership

All facility ownership & control disclosures 9

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

Facilities with the same owner 90

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Avera at Home

  • Community Based Hospice Care Agency
  • Yankton, SD
  • NPI 1003982893

  Avera Health

  CMS ownership
• Avera at Home

  • Inpatient Hospice
  • Mitchell, SD
  • NPI 1124023825

  Avera Health

  CMS ownership
• Avera at Home

  • Community Based Hospice Care Agency
  • Aberdeen, SD
  • NPI 1194777961

  Avera Health

  CMS ownership
• Avera at Home

  • Home Health Agency
  • Mitchell, SD
  • NPI 1215932918

  Avera Health

  CMS ownership
• Avera at Home

  • Home Health Agency
  • Pierre, SD
  • NPI 1336579127

  Avera Health

  CMS ownership
• Avera at Home

  • Community Based Hospice Care Agency
  • Pierre, SD
  • NPI 1427488212

  Avera Health

  CMS ownership
• Avera at Home

  • Community Based Hospice Care Agency
  • Sioux Falls, SD
  • NPI 1467474239

  Avera Health

  CMS ownership
• Avera at Home

  • Community Based Hospice Care Agency
  • Milbank, SD
  • NPI 1467565325

  Avera Health

  CMS ownership
• Avera at Home

  • Home Health Agency
  • Milbank, SD
  • NPI 1558474411

  Avera Health

  CMS ownership
• Avera at Home

  • Home Health Agency
  • Sioux Falls, SD
  • NPI 1649691320

  Avera Health

  CMS ownership
• Avera at Home

  • Home Health Agency
  • Yankton, SD
  • NPI 1851467773

  Avera Health

  CMS ownership
• Avera at Home

  • Home Health Agency
  • Aberdeen, SD
  • NPI 1912958877

  Avera Health

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kasey J Hanson, CNP

  • Family Nurse Practitioner
  • Chamberlain, SD
  • NPI 1346246493
  NPD
• Erin A Tobin, CNP

  • Nurse Practitioner
  • Gregory, SD
  • NPI 1235430042
  NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1912959495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 W 2ND ST",
            "address_2": "PO BOX 705",
            "city": "WINNER",
            "state": "SD",
            "postal_code": "575801218",
            "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": "660 W 2ND ST",
            "city": "WINNER",
            "state": "SD",
            "postal_code": "575801218",
            "telephone_number": "605-842-2443",
            "fax_number": "605-842-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA MCKENNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "NORTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "605-322-6375",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Winner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• All providers in Winner, SD
• Rural Health Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.