AVERA MCKENNAN (NPI# 1548233885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548233885 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA DOCTORS PLAZA IMAGING CENTER |
| Practice Address |
1001 E 21st St Ste. 403 Sioux Falls SD 57105-1033 |
| Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
| Practice Telephone | 6053221745 |
| Practice Fax Number | 6053221746 |
| Mailing Telephone | 6053227510 |
| Mailing Fax Number | 6053226475 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2012-03-12 |
| Authorized Official Name | JULIE N NORTON (SENIOR VP OF FINANCE) |
| Authorized Official Telephone | 6053226375 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | DEPT OF LABOR | 370624200 | 01 |
| NE | 10025121100 | 05 | |
| MN | BLUE PLUS | 543R6AV | 01 |
| Other Name | Type Code |
|---|---|
| Avera Doctors Plaza Imaging Center | 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 |
1001 E 21ST ST STE. 403 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134191869 | Kozhikode Veetil Narayanan Menon | Internal Medicine | 1001 E 21st St, Suite 303, Sioux Falls, SD 57105-1033 | 2006-02-06 |
| 1154552412 | Trisha H Justice | Nurse Practitioner | 1001 E 21st St, Ste 010, Sioux Falls, SD 57105-1033 | 2009-08-05 |
| 1114957818 | Pediatric Surgical Associates PC | Surgery | 1001 E 21st St, Ste # 012, Sioux Falls, SD 57105-1033 | 2006-07-05 |
| 1295782613 | Stephen R Karl | Surgery | 1001 E 21st St, Ste # 012, Sioux Falls, SD 57105-1033 | 2006-05-30 |
| 1437125119 | Tina M Melanson | Internal Medicine | 1001 E 21st St, Ste. 300, Sioux Falls, SD 57105-1033 | 2006-02-23 |
| 1770555245 | Patricia J Bunger | Pediatrics | 1001 E 21st St, Ste. 200, Sioux Falls, SD 57105-1033 | 2006-02-07 |
| 1619949153 | Mary K Kunde | Psychologist | 1001 E 21st St, Ste. 100, Sioux Falls, SD 57105-1033 | 2006-02-07 |
| 1356313928 | Paula K. Pardy | Obstetrics & Gynecology | 1001 E 21st St, Sioux Falls, SD 57105-1017 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992024137 | Jackalyn Spry | Radiologic Technologist | 4500 E Hwy 18, Pine Ridge, SD 57770 | 2010-05-27 |
| 1205096682 | Patrick Mcfarland | Radiologic Technologist | 420 4th St Ne Ste 122, Watertown, SD 57201-2658 | 2008-06-10 |
| 1770513475 | Mitchell Diagnostic | Radiologic Technologist | 2250 N Kimball St Ste 600, Mitchell, SD 57301-5335 | 2006-07-05 |
| 1508263690 | Monica Hanson | Radiologic Technologist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2014-12-04 |
| 1851726376 | Jennifer Marie Fuhr | Radiologic Technologist | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2013-09-04 |
| 1447577580 | Kami H Wolf | Radiologic Technologist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2010-04-29 |
| 1831416973 | Debra M Meyers | Radiologic Technologist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2010-04-29 |
| 1871810911 | Sherry L Langstaff | Radiologic Technologist | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2010-04-29 |
| 1730419557 | Elijah John Wolfe | Radiologic Technologist | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2009-12-29 |
| 1326273707 | Brenda Ann Jackson | Radiologic Technologist | 100 Lake Traverse Dr, Sisseton, SD 57262-7046 | 2009-05-28 |
| Find all providers with the same taxonomy | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
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.