AVERA MCKENNAN


Address: 310 W Sd Highway 46, Wagner, SD 57380-9304
Phone: 6053844980

AVERA MCKENNAN (NPI# 1538527106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538527106
Entity Type Organization
Organization Name AVERA MCKENNAN
Other Organization Name AVERA DIALYSIS WAGNER
Practice Address 310 W Sd Highway 46
Wagner
SD 57380-9304
Mailing Address Po Box 5045
Pfs Prov Enrllmt
Sioux Falls
SD 57117-5045
Practice Telephone 6053844980
Practice Fax Number 6053844990
Mailing Telephone 6053226404
Enumeration Date 2016-02-10
Last Update Date 2016-10-10
Authorized Official Name JULIE NORTON (CFO/SVP)
Authorized Official Telephone 6053227818
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QE0700X Clinic/Center
Specialization: End-Stage Renal Disease (ESRD) Treatment
10563 SD Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
SD WELLMARK BCBS 1538527106 01

Other Provider/Organization Names

Other Name Type Code
Avera Dialysis Wagner Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 310 W SD HIGHWAY 46
City WAGNER
State SD
Zip Code 57380-9304

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609013317 Douglas County Memorial Hospital Clinic/Center 310 W Sd Highway 46, Wagner, SD 57380-9304 2009-01-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083070593 Carol Lee Stewart Nurse Practitioner 513 3rd Street Sw, Wagner, SD 57380 2016-01-13
1174906705 Jerika Kirwan Optometrist 720 West Hwy 46, Wagner, SD 57380 2015-07-01
1134334766 Drew Tyler Anderson Chiropractor 109 1st St Sw, Wagner, SD 57380 2007-05-14
1326066796 Wagner Indian Health Service Health Center Clinic/Center 111 Washington Ave, Wagner, SD 57380 2006-07-17
1447220603 Jay Joseph Fitzgerald Chiropractor 109 1st. St. Sw, Wagner, SD 57380 2006-01-23
1649759499 The Evangelical Lutheran Good Samaritan Society Nurse Practitioner 515 W Highway 46, Wagner, SD 57380 2018-08-13
1972754422 Timothy Eric Sass Pharmacist 111 Washington Ave Nw, Wagner, SD 57380 2008-10-02
1275741878 Patricia Ann Goulette Registered Nurse 111 Washington Ave Nw, Wagner, SD 57380 2007-05-18
1073721510 Barbara Slaba Registered Nurse 111 Washington Ave Nw, Wagner, SD 57380 2007-05-18
1225246770 Martha J Geuther Registered Nurse 111 Washington Ave Nw, Wagner, SD 57380 2007-05-18
Find all providers in zip 57380

Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326060054 Sanford Medical Center Clinic/Center 111 Washington St, Wagner, SD 57380 2006-07-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437502614 Total Renal Care Inc Clinic/Center 3313 6th Ave Se, Aberdeen, SD 57401-5504 2016-07-22
1922318666 Dialysis Management Group LLC Clinic/Center Hcr 49, Porcupine, SD 57772-0000 2010-10-15
1255415246 Monument Health Rapid City Hospital, Inc. Clinic/Center 132 Yankee St, Spearfish, SD 57783-2948 2006-10-25
1184711061 Total Renal Care Clinic/Center 400 Park, Gregory, SD 57533 2006-10-10
1710087713 Black Hills Dialysis, LLC Clinic/Center 100 Dialysis Drive, Pine Ridge, SD 57770-3013 2006-09-22
1356301519 Total Renal Care Inc Clinic/Center 1 Soldier Creek Rd, Rosebud, SD 57570-0610 2006-03-23
1033178660 Total Renal Care Inc Clinic/Center 2326 W 69th St, Sioux Falls, SD 57108-5600 2006-03-22
1477512093 Total Renal Care Inc Clinic/Center 819 E Spruce St, Ste 100, Mitchell, SD 57301-4800 2006-03-22
1487621116 Monument Health Rapid City Hospital, Inc. Clinic/Center 640 Flormann St Ste 401, Rapid City, SD 57701-4679 2006-03-01
1881110484 Sanford Medical Center Clinic/Center 1321 W 22nd St, Sioux Falls, SD 57105-1502 2017-08-16
Find all providers with the same taxonomy

Competitor

Search similar providers

City WAGNER
Zip Code 57380

Improve Information

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Dataset Information

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.

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