AVERA MCKENNAN (NPI# 1467786640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467786640 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA PRINCE OF PEACE OUTPATIENT THERAPY |
| Practice Address |
4500 S Prince of Peace Pl Suite 1 Sioux Falls SD 57103-5830 |
| Mailing Address |
800 E 21st St Po Box 5045, Prov Enrollment Sioux Falls SD 57105-1016 |
| Practice Telephone | 6053225618 |
| Mailing Telephone | 6053226400 |
| Mailing Fax Number | 6053226499 |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2010-05-21 |
| Authorized Official Name | JULIE N NORTON (VP/CFO) |
| Authorized Official Telephone | 6053226375 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
10563 | SD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1467786640 | 05 | |
| NE | 10025846600 (PT ) | 05 | |
| NE | 10025846700 (OT GRP) | 05 | |
| SD | DAKOTACARE | 9290262 | 01 |
| IA | 1467786640 | 05 |
| Other Name | Type Code |
|---|---|
| Avera Prince of Peace Outpatient Therapy | 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 |
4500 S PRINCE OF PEACE PL SUITE 1 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57103-5830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508854340 | Avera Mckennan | Assisted Living Facility | 4500 S Prince of Peace Pl, Sioux Falls, SD 57103-5830 | 2005-10-06 |
| 1841712858 | Kyle Mollet | Occupational Therapist | 4500 S Prince of Peace Pl, Sioux Falls, SD 57103-5830 | 2017-07-11 |
| 1326438581 | Kristen Plank | Occupational Therapist | 4500 S Prince of Peace Pl, Sioux Falls, SD 57103-5830 | 2015-01-27 |
| 1114316411 | Sarah Maurer | Occupational Therapist | 4500 S Prince of Peace Pl, Sioux Falls, SD 57103-5830 | 2015-01-10 |
| 1720412802 | Ann Rachelle Allender | Occupational Therapist | 4500 S Prince of Peace Pl, Sioux Falls, SD 57103-5830 | 2013-08-26 |
| 1043584931 | Martha J Frohwein | Physical Therapist | 4500 S Prince of Peace Pl, Sioux Falls, SD 57103-5830 | 2012-02-24 |
| 1992961072 | Rodger Francis Hahne | Physical Therapist | 4500 S Prince of Peace Pl, Suite 1, Sioux Falls, SD 57103-5830 | 2008-07-29 |
| 1780849869 | Renee Kneip | Occupational Therapist | 4500 S Prince of Peace Pl, Suite 1, Sioux Falls, SD 57103-5830 | 2008-07-28 |
| 1376708446 | Stephanie Ann Rahn I | Physical Therapist | 4500 S Prince of Peace Pl, Sioux Falls, SD 57103-5830 | 2008-07-28 |
| 1700070307 | Jodie Mcmacken Thorson | Occupational Therapist | 4500 S Prince of Peace Pl, Suite 1, Sioux Falls, SD 57103-5830 | 2007-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972072858 | Tasha Leigh Vanrooyen | Massage Therapist | 3400 Southeastern Avenue, Sioux Falls, SD 57103 | 2018-11-20 |
| 1407377328 | Minnehaha Health Supplies | Durable Medical Equipment & Medical Supplies | Sioux Falls - Cna Building, 101 South Reid Street, Suite 307, Sioux Falls, SD 57103 | 2017-06-30 |
| 1811378771 | African Community Center of Sioux Falls | Non-emergency Medical Transport (VAN) | 1515 East 10th Street, Sioux Falls, SD 57103 | 2015-06-16 |
| 1033596861 | Raichatou Ann Jackson | Clinical Nurse Specialist | 4308 Est 9th St, Sioux Falls, SD 57103 | 2015-04-30 |
| 1538551668 | Wendy Jo Kranzler | Occupational Therapist | 4500 Prince of Peace, Sioux Falls, SD 57103 | 2015-02-26 |
| 1932477205 | Alpha Sigma Health Group, Inc. | Home Health | 2804 East 26th Street, Lower Level, Sioux Falls, SD 57103 | 2011-12-01 |
| 1629207089 | Andrea R Tuley | Registered Nurse | 1312 E. 11th Street, Sioux Falls, SD 57103 | 2009-07-07 |
| 1891920054 | Great Plains Chiropractic & Wellness LLC | Chiropractor | 3233 S. Sycamore Ave., Sioux Falls, SD 57103 | 2009-05-18 |
| 1841430162 | Martin Frank Petereit | Radiology | 1600 E. Cedar Lane, Retired Radiologist, Sioux Falls, SD 57103 | 2009-02-26 |
| 1255518619 | Mobile Sonographers Inc | Spec/Tech, Cardiovascular | 2307 E Harriet Lea St, Sioux Falls, SD 57103 | 2008-01-29 |
| Find all providers in zip 57103 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811381817 | Premise Health of South Dakota PC | Clinic/Center | 2200 E Benson Rd, Sioux Falls, SD 57104-7023 | 2015-03-27 |
| 1114246576 | Avera Mckennan | Clinic/Center | 1200 S 7th Ave, Suite 2, Sioux Falls, SD 57105-0900 | 2010-05-25 |
| 1245263326 | Orthopedic Institute PC | Clinic/Center | 810 E 23rd St, Sioux Falls, SD 57105-2135 | 2006-07-09 |
| 1386620607 | Gpps LLC | Clinic/Center | 4105 S Carnegie Pl, Sioux Falls, SD 57106-2360 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598231334 | Regional Health Physicians, Inc. | Clinic/Center | 1635 Caregiver Circle, Rapid City, SD 57702 | 2018-10-19 |
| 1144707472 | Pure Medical Aesthetics | Clinic/Center | 525 Kansas City St, Rapid City, SD 57701-3673 | 2018-07-19 |
| 1982057246 | City of Brookings | Clinic/Center | 310 22nd Avenue, Brookings, SD 57006 | 2016-07-21 |
| 1700090560 | Regional Health Physicians Inc | Clinic/Center | 101 East Third Street, Newell, SD 57760-0468 | 2007-05-10 |
| 1770502460 | Monument Health Network, Inc. | Clinic/Center | 2140 Junction Avenue, Sturgis, SD 57785-2358 | 2006-07-19 |
| 1063458263 | Regional Health Physicians Inc | Clinic/Center | 557 E Main Street, Hill City, SD 57745-0000 | 2006-06-22 |
| 1174569347 | Monument Health Network, Inc. | Clinic/Center | 1440 N Main Street, Spearfish, SD 57783-1505 | 2006-06-22 |
| 1609849165 | Dakota Hills Family Practice | Clinic/Center | 1010 Ballpark Rd, Suite 2, Sturgis, SD 57785-2364 | 2006-02-07 |
| 1841706686 | Monument Health Network, Inc. | Clinic/Center | 2140 Junction Ave, Sturgis, SD 57785-2358 | 2017-12-15 |
| 1588185268 | Monument Health Network, Inc. | Clinic/Center | 1100 Highway 71 S Ste 101, Hot Springs, SD 57747-8801 | 2017-07-03 |
| Find all providers with the same taxonomy | ||||
| City | SIOUX FALLS |
| Zip Code | 57103 |
Please comment or provide details below to improve the information on AVERA MCKENNAN.
| 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.