AVERA MCKENNAN (NPI# 1063782373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063782373 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA MEDICAL GROUP BROOKINGS |
| Practice Address |
400 22nd Ave Brookings SD 57006-2497 |
| Practice Telephone | 6056979500 |
| Mailing Telephone | 6056979500 |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |
| Authorized Official Name | JULIE NORTON (VP EXECUTIVE) |
| Authorized Official Telephone | 6053227818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Brookings | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154979805 | Avera Mckennan | Substance Abuse Rehabilitation Facility | 6140 S Curae Lane, Sioux Falls, SD 57108-3047 | 2019-08-27 |
| 1205311628 | Avera Mckennan | Pharmacy | 6100 S Louise Ave Ste 1100, Sioux Falls, SD 57108-6021 | 2018-10-02 |
| 1316463219 | Avera Mckennan | Pharmacy | 1200 S. 7th Avenue, Suite 101, Sioux Falls, SD 57105 | 2017-08-22 |
| 1851848444 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 2100 S Marion Road, Ste 125, Sioux Falls, SD 57106-3645 | 2016-09-01 |
| 1295187417 | Avera Mckennan | Psychiatry & Neurology | 6709 S. Minnesota Ave., Ste. 103, Sioux Falls, SD 57108-2593 | 2016-07-12 |
| 1669871000 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 3820 N Potsdam Ave Ste 2, Sioux Falls, SD 57104-7057 | 2014-08-21 |
| 1922413806 | Avera Mckennan | Clinic/Center | 400 2nd Ave, Brookings, SD 57006 | 2014-06-30 |
| 1629499132 | Avera Mckennan | Occupational Therapist | 1601 W 44th Pl, Sioux Falls, SD 57105-6376 | 2013-12-31 |
| 1700146396 | Avera Mckennan | Clinic/Center | 1035 South Highline Pl, Ste #4, Sioux Falls, SD 57110 | 2012-05-17 |
| 1467711739 | Avera Mckennan | Pharmacy | 1301 S Cliff Ave Ste 225, Sioux Falls, SD 57105-1068 | 2012-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | AVERA MCKENNAN | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 |
| Iowa Business Entities | AVERA MCKENNAN | 1325 S. Cliff St., Sioux Falls, SD 57105 |
| System for Award Management (SAM) Entities | AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 |
| Street Address |
400 22ND AVE |
| City | BROOKINGS |
| State | SD |
| Zip Code | 57006-2497 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568461804 | Janine Dawn Bassett | Nurse Practitioner | 400 22nd Ave, Brookings, SD 57006-2450 | 2005-07-19 |
| 1194325712 | Travis Bolstad | Physical Therapist | 400 22nd Ave, Brookings, SD 57006-2450 | 2020-11-01 |
| 1437638152 | Courtney Falk | Physical Therapist | 400 22nd Ave, Brookings, SD 57006-2450 | 2018-08-13 |
| 1407364391 | Sara Ruth Peterson-baker | Physical Therapist | 400 22nd Ave, Brookings, SD 57006-2450 | 2018-01-14 |
| 1174048235 | Sarah Sapp | Nurse Practitioner | 400 22nd Ave, Brookings, SD 57006-2450 | 2017-08-10 |
| 1841651825 | Tyler Richard Harrell | Podiatrist | 400 22nd Ave, Brookings, SD 57006-2450 | 2016-03-17 |
| 1851797948 | Jennifer Anderson | Nurse Practitioner | 400 22nd Ave, Brookings, SD 57006-2450 | 2014-11-17 |
| 1437567427 | Karley Fischer | Physician Assistant | 400 22nd Ave, Brookings, SD 57006-2497 | 2014-07-23 |
| 1548677362 | Ali Marie Koopmans | Physical Therapist | 400 22nd Ave, Brookings, SD 57006-2497 | 2014-07-14 |
| 1033525522 | Jennifer Ann Redmond | Nurse Practitioner | 400 22nd Ave, Brookings, SD 57006-2450 | 2014-07-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720685845 | Leah Kroeger | Specialist/Technologist | 2820 Stanley J Marshall Center, Brookings, SD 57006 | 2020-10-01 |
| 1619454774 | Alec Edward Weis | Student in an Organized Health Care Education/Training Program | 314 Main Ave Apt 4., Brookings, SD 57006 | 2018-07-22 |
| 1629569066 | Robin Lynn Erz | Counselor | East Central Behavioral Health, 211 4th Street, Brookings, SD 57006 | 2018-05-22 |
| 1982057246 | City of Brookings | Clinic/Center | 310 22nd Avenue, Brookings, SD 57006 | 2016-07-21 |
| 1922413806 | Avera Mckennan | Clinic/Center | 400 2nd Ave, Brookings, SD 57006 | 2014-06-30 |
| 1093157554 | Nathan William Hilbrands | Dentist | 427 8th St S, Brookings, SD 57006 | 2013-07-25 |
| 1992073951 | Andrea Uckert | Counselor | 619 5th Ave Ste 3, Brookings, SD 57006 | 2011-12-06 |
| 1972800100 | Melissa Ann Klemm | Counselor | 1304 Main Ave S, Brookings, SD 57006 | 2011-02-24 |
| 1285873539 | Amy Lynn Osterberg | Counselor | 211 4th St., East Central Mh/cd Center Inc, Brookings, SD 57006 | 2009-02-10 |
| 1114062072 | Kendalls Rexall Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 223 6th St, Brookings, SD 57006 | 2007-02-20 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548434889 | Scsa Diagnostics, Inc. | Clinical Medical Laboratory | 807 32nd Ave, Brookings, SD 57006-4716 | 2008-04-17 |
| 1790906451 | Jeanine Rae Dodson | Clinical Medical Laboratory | 927 5th St, So. #5, Brookings, SD 57006-3349 | 2007-05-01 |
| 1629176367 | Southern Oregon Sleep Center Inc | Clinical Medical Laboratory | 16289 Highway 101 S, Unit D, Brookings, OR 97415-8404 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134302177 | City of Sioux Falls | Clinical Medical Laboratory | 521 N. Main Ave., Suite 100, Sioux Falls, SD 57104-5947 | 2007-12-13 |
| 1366544769 | Mga Lab Inc | Clinical Medical Laboratory | 1115 East 5th, Mitchell, SD 57301-1003 | 2006-09-05 |
| 1124133236 | Siouxland Pathology | Clinical Medical Laboratory | 350 W Anchor Dr, Suite 200, Dakota Dunes, SD 57049-5335 | 2006-08-20 |
| 1861429110 | State of South Dakota Division of Oasi | Clinical Medical Laboratory | 615 E 4th St, Pierre, SD 57501-1700 | 2006-06-26 |
| 1326024720 | Laboratory Corporation of America | Clinical Medical Laboratory | 713 Omaha St, Rapid City, SD 57701-2761 | 2005-12-16 |
| 1184626962 | Huron Clinic Foundation Ltd | Clinical Medical Laboratory | 111 4th St Se, Huron, SD 57350-2509 | 2005-08-11 |
| 1528627361 | Avera Mckennan | Clinical Medical Laboratory | 3720 W 69th St, Sioux Falls, SD 57108-8192 | 2019-06-06 |
| 1417428434 | Rapid City Regional Hospital, Inc. | Clinical Medical Laboratory | 1635 Caregiver Circle, Rapid City, SD 57702-8529 | 2018-12-17 |
| 1326523754 | Regional Health Network, Inc. | Clinical Medical Laboratory | 2140 Junction Ave, Sturgis, SD 57785-2358 | 2018-10-02 |
| 1528543956 | Regional Health Network, Inc. | Clinical Medical Laboratory | 1220 Montgomery St, Custer, SD 57730-1705 | 2018-10-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.