AVERA MCKENNAN (NPI# 1760681175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760681175 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | MOODY COUNTY PUBLIC HEALTH |
| Practice Address |
309 N Prairie St Flandreau SD 57028-1253 |
| Practice Telephone | 6059973779 |
| Practice Fax Number | 6059973273 |
| Mailing Telephone | 6059973779 |
| Mailing Fax Number | 6059973273 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2012-03-09 |
| Authorized Official Name | BARB J. SHEA (BUSINESS OFFICE ASSISTANT) |
| Authorized Official Telephone | 6059973779 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 5102100 | 05 |
| Other Name | Type Code |
|---|---|
| Moody County Public Health | 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 |
309 N PRAIRIE ST |
| City | FLANDREAU |
| State | SD |
| Zip Code | 57028-1253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932319589 | Avera Mckennan | Home Health | 309 N Prairie St, Flandreau, SD 57028-1253 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689865081 | John Roy Sivesind | Psychologist | 107 W Broad Ave, Flandreau, SD 57028 | 2007-08-09 |
| 1649200189 | James Shaeffer | Family Medicine | 701 West Broad Ave, Flandreau, SD 57028 | 2006-07-03 |
| 1437188729 | Flandreau Santee Sioux Tribe | Clinic/Center | 403 W Broad Ave, Flandreau, SD 57028 | 2006-07-01 |
| 1629018445 | Clay Joseph Pavlis | Psychiatry & Neurology | 809 W Pipestone Ave Ste 8, Flandreau, SD 57028 | 2006-06-08 |
| 1851729552 | Midwest Wellness Institute, Pllc | Clinic/Center | 809 W Pipestone Ave Ste 8, Flandreau, SD 57028 | 2013-10-16 |
| 1407993165 | Flandreau School District #50-3 | Local Education Agency (LEA) | 600 W Community Dr, Flandreau, SD 57028-1060 | 2007-01-31 |
| 1447807466 | Kali Marie Ahlers | Psychologist | 600 W Community Dr, Flandreau, SD 57028-1060 | 2019-08-23 |
| 1487200291 | Suzannah Eileen Cleveland | Speech-Language Pathologist | 600 W Community Dr, Flandreau, SD 57028-1060 | 2019-08-16 |
| 1043785496 | Adriane Voisin | Speech-Language Pathologist | 600 W Community Dr, Flandreau, SD 57028-1060 | 2018-10-11 |
| 1922598770 | Katherine E Krystosek | Specialist/Technologist | 600 W Community Dr, Flandreau, SD 57028-1060 | 2018-05-17 |
| Find all providers in zip 57028 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932327624 | Great Plains Tribal Chairmen's Health Board | Public Health or Welfare | 2611 Elderberry Blvd, Rapid City, SD 57703-5970 | 2007-04-20 |
| 1982616595 | Sd Department of Social Services - Orfi | Public Health or Welfare | 700 Governors Dr, Pierre, SD 57501-2291 | 2006-08-12 |
| 1992727366 | State of South Dakota Division of Oasi | Public Health or Welfare | 302 E Dakota Ave, Pierre, SD 57501-3133 | 2006-07-24 |
| 1699793323 | State of South Dakota Division of Oasi | Public Health or Welfare | 909 S Miller Ave, Mitchell, SD 57301-4114 | 2006-07-18 |
| 1558395848 | Eagle Butte Indian Health Service Hospital | Public Health or Welfare | 24276 166th Street, Airport Road, Eagle Butte, SD 57625-1012 | 2006-07-10 |
| 1831113315 | State of South Dakota Division of Oasi | Public Health or Welfare | 600 E Capitol Ave, Pierre, SD 57501-2536 | 2006-07-27 |
| 1740204221 | State of South Dakota Division of Oasi | Public Health or Welfare | 600 E Capitol Ave, Pierre, SD 57501-2536 | 2006-07-27 |
| 1114940368 | State of South Dakota Division of Oasi | Public Health or Welfare | 600 E Capitol Ave, Pierre, SD 57501-2536 | 2006-07-26 |
| 1467470179 | State of South Dakota Division of Oasi | Public Health or Welfare | 402 S Main St, Aberdeen, SD 57401-4127 | 2006-07-18 |
| 1801839428 | Thorn-jetson Corporation | Public Health or Welfare | 636 Saint Anne St, Suite 201, Rapid City, SD 57701-4694 | 2006-06-13 |
| 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.