AVERA MCKENNAN (NPI# 1750488730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750488730 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA MEDICAL GROUP MILBANK |
| Practice Address |
803 E Milbank Ave Milbank SD 57252-1413 |
| Mailing Address |
803 E Milbank Ave Po Box 69 Milbank SD 57252-1413 |
| Practice Telephone | 6054324587 |
| Mailing Telephone | 6054324587 |
| Mailing Fax Number | 6054324580 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-08-30 |
| Authorized Official Name | JULIE N NORTON (CFO) |
| Authorized Official Telephone | 6053226375 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN MEDICAID | 148019700 | 01 | |
| SD | MEDICAID SD | 10148 | 01 |
| CLIA | 43D0407375 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Milbank | 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 |
803 E MILBANK AVE |
| City | MILBANK |
| State | SD |
| Zip Code | 57252-1413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992701619 | Nanci J Vanpeursem | Family Medicine | 803 E Milbank Ave, Milbank, SD 57252-1413 | 2005-06-27 |
| 1992158760 | Elizabeth Van Lith | Physician Assistant | 803 E Milbank Ave, Milbank, SD 57252-1413 | 2016-07-18 |
| 1649234428 | Vichit Vanadurongvan | General Practice | 803 E Milbank Ave, Milbank, SD 57252-1413 | 2006-04-17 |
| 1770547598 | Kevin L Bjordahl | Family Medicine | 803 E Milbank Ave, Milbank, SD 57252-1413 | 2006-04-17 |
| 1760446603 | Kanya Vanadurongvan | General Practice | 803 E Milbank Ave, Milbank, SD 57252-1413 | 2006-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629319231 | Erin Elizabeth Kannegieter | Physical Therapy Assistant | 1103 South 2nd Street, Milbank, SD 57252 | 2013-03-06 |
| 1376838839 | Paul Thrasher Denna | General Practice | 803 E. Milbank Ave., Milbank, SD 57252 | 2011-06-13 |
| 1063593275 | Mark A Bierschbach D.d.s., P.C. | Dentist | 1203 East 4th Ave., Suite 103, Milbank, SD 57252 | 2006-10-17 |
| 1336686500 | Wapiti Medical Group Limited Company | Internal Medicine | 107 Flynn Dr Ste 600, Milbank, SD 57252 | 2017-01-26 |
| 1083636773 | Alan David Bergquist | Chiropractor | 1203 E. 4th Ave. Suite 101, Milbank, SD 57252-0230 | 2006-07-24 |
| 1962620260 | Whetstone Valley Electric Cooperative | Technician, Other | 1101 E 4th Ave, Milbank, SD 57252-0512 | 2007-04-23 |
| 1639383383 | Wapiti Medical Corporation | Specialist | 603 S Dakota St, Milbank, SD 57252-0523 | 2007-05-10 |
| 1093909616 | Mary G Bray | Occupational Therapy Assistant | 309 N Bell Ave, Milbank, SD 57252-1302 | 2007-08-28 |
| 1013024009 | Avera Mckennan | Clinic/Center | 301 Flynn Dr, Milbank, SD 57252-1502 | 2006-08-24 |
| 1326154220 | Avera Mckennan | Medicare Defined Swing Bed Unit | 301 Flynn Dr, Milbank, SD 57252-1502 | 2006-08-22 |
| Find all providers in zip 57252 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447803432 | City of Brookings | Clinic/Center | 104 1/2 West 2nd Street, Elkton, SD 57026 | 2019-07-19 |
| 1477942878 | Platte Community Memorial Hospital, Inc | Clinic/Center | 306 S Johnston St, White Lake, SD 57383-2251 | 2015-01-22 |
| 1003230541 | Regional Health Physicians, Inc. | Clinic/Center | 112 7th Avenue, Wall, SD 57790 | 2014-02-04 |
| 1912279829 | City of Brookings | Clinic/Center | 302 E 5th Street, White, SD 57276-2061 | 2012-02-08 |
| 1902187032 | Community Memorial Hospital Inc | Clinic/Center | 314 Mellette St, Bonesteel, SD 57317 | 2011-09-02 |
| 1609013317 | Douglas County Memorial Hospital | Clinic/Center | 310 W Sd Highway 46, Wagner, SD 57380-9304 | 2009-01-16 |
| 1750422655 | Regional Health Physicians Inc | Clinic/Center | 114 E Main Street, Hill City, SD 57745 | 2007-02-12 |
| 1326189754 | Regional Health Physicians Inc | Clinic/Center | 101 E. Third St., Newell, SD 57760 | 2007-02-09 |
| 1609931518 | Sioux Valley Clinic | Clinic/Center | 600 W Cedar Street (highway 46), Beresford, SD 57004 | 2006-12-22 |
| 1588677892 | Avera Mckennan | Clinic/Center | 305 N 2nd Ave, Revillo, SD 57259-0006 | 2006-08-15 |
| Find all providers with the same taxonomy | ||||
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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.