AVERA MCKENNAN (NPI# 1891718136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891718136 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA MCKENNAN REGIONAL LAB |
| Practice Address |
1301 S Cliff Ave Regional Lab Sioux Falls SD 57105-1005 |
| Mailing Address |
Po Box 5045 Attn: P.f.s. Sioux Falls SD 57117-5045 |
| Practice Telephone | 6053227187 |
| Practice Fax Number | 6053227183 |
| Mailing Telephone | 6053227187 |
| Mailing Fax Number | 6053227183 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2011-04-07 |
| Authorized Official Name | JULIE NORTON (VP/CFO) |
| Authorized Official Telephone | 6053226375 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 43D0658878 | SD | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | BLUE CROSS OF SD | 4995742 | 01 |
| MN | BLUE CROSS OF MINNESOTA | 165L6AV | 01 |
| IA | 0569285 | 05 | |
| SD | PREFERRED ONE | 1034593 | 01 |
| SD | 5580610 | 05 | |
| SD | ARAZ | 604999 | 01 |
| SD | MIDLANDS CHOICE | F230764 | 01 |
| Other Name | Type Code |
|---|---|
| Avera McKennan Regional Lab | 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 |
1301 S CLIFF AVE REGIONAL LAB |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194723924 | Henry Travers | Pathology | 1301 S Cliff Ave, Suite 700, Sioux Falls, SD 57105-1019 | 2005-07-14 |
| 1245864693 | Rachel Wolkow | Nurse Practitioner | 1301 S Cliff Ave, Sioux Falls, SD 57105-1005 | 2020-02-25 |
| 1942723838 | Holly M Bonnichsen | Audiologist | 1301 S Cliff Ave, Sioux Falls, SD 57105-1005 | 2017-07-21 |
| 1194276956 | Nicole Rae Nelson | Nurse Practitioner | 1301 S Cliff Ave, #610, Sioux Falls, SD 57105-1005 | 2016-10-17 |
| 1780134023 | Andrew Jacob Murtha | Nurse Practitioner | 1301 S Cliff Ave, Sioux Falls, SD 57105-1005 | 2016-10-11 |
| 1003269176 | Paul Stamp | Nurse Practitioner | 1301 S Cliff Ave, Suite 610, Sioux Falls, SD 57105-1005 | 2016-07-13 |
| 1639535198 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 1301 S Cliff Ave, Ste. 220, Sioux Falls, SD 57105-1005 | 2016-01-13 |
| 1801274626 | Melissa Mathiowetz | Physical Therapist | 1301 S Cliff Ave, Suite 402, Sioux Falls, SD 57105-1005 | 2015-05-13 |
| 1831590447 | Rebecca Gayle Hruby | Nurse Practitioner | 1301 S Cliff Ave, Suite 506, Sioux Falls, SD 57105-1005 | 2014-09-15 |
| 1427463371 | Elizabeth Cecilia Stauss | Nurse Practitioner | 1301 S Cliff Ave, Plaza 2 Suite 401, Sioux Falls, SD 57105-1005 | 2014-06-29 |
| Find all providers in the same location | ||||
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134302177 | City of Sioux Falls | Clinical Medical Laboratory | 521 N. Main Ave., Suite 100, Sioux Falls, SD 57104-5947 | 2007-12-13 |
| 1528627361 | Avera Mckennan | Clinical Medical Laboratory | 3720 W 69th St, Sioux Falls, SD 57108-8192 | 2019-06-06 |
| 1306291901 | Omegaquant | Clinical Medical Laboratory | 5009 W 12th St, Suite 8, Sioux Falls, SD 57106-3988 | 2016-05-02 |
| 1326311721 | Sanford Clinic | Clinical Medical Laboratory | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2012-02-15 |
| 1770742496 | Lcm Pathologists PC | Clinical Medical Laboratory | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2008-06-06 |
| 1346410115 | Sanford Clinic | Clinical Medical Laboratory | 1321 W 22nd St, Sioux Falls, SD 57105-1502 | 2008-03-07 |
| 1457578767 | Sanford School of Medicine of The University of South Dakota Clinical | Clinical Medical Laboratory | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2007-04-19 |
| 1487747044 | Sanford School of Medicine The University of Sd Clinical Virolog Lab | Clinical Medical Laboratory | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2006-10-02 |
| 1841242542 | Sanford Medical Center | Clinical Medical Laboratory | 1205 S Grange Ave, Sioux Falls, SD 57105-0407 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548434889 | Scsa Diagnostics, Inc. | Clinical Medical Laboratory | 807 32nd Ave, Brookings, SD 57006-4716 | 2008-04-17 |
| 1790906451 | Jeanine Rae Dodson | Clinical Medical Laboratory | 927 5th St, So. #5, Brookings, SD 57006-3349 | 2007-05-01 |
| 1366544769 | Mga Lab Inc | Clinical Medical Laboratory | 1115 East 5th, Mitchell, SD 57301-1003 | 2006-09-05 |
| 1124133236 | Siouxland Pathology | Clinical Medical Laboratory | 350 W Anchor Dr, Suite 200, Dakota Dunes, SD 57049-5335 | 2006-08-20 |
| 1861429110 | State of South Dakota Division of Oasi | Clinical Medical Laboratory | 615 E 4th St, Pierre, SD 57501-1700 | 2006-06-26 |
| 1326024720 | Laboratory Corporation of America | Clinical Medical Laboratory | 713 Omaha St, Rapid City, SD 57701-2761 | 2005-12-16 |
| 1184626962 | Huron Clinic Foundation Ltd | Clinical Medical Laboratory | 111 4th St Se, Huron, SD 57350-2509 | 2005-08-11 |
| 1417428434 | Rapid City Regional Hospital, Inc. | Clinical Medical Laboratory | 1635 Caregiver Circle, Rapid City, SD 57702-8529 | 2018-12-17 |
| 1326523754 | Regional Health Network, Inc. | Clinical Medical Laboratory | 2140 Junction Ave, Sturgis, SD 57785-2358 | 2018-10-02 |
| 1528543956 | Regional Health Network, Inc. | Clinical Medical Laboratory | 1220 Montgomery St, Custer, SD 57730-1705 | 2018-10-02 |
| Find all providers with the same taxonomy | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
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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.