AVERA MCKENNAN (NPI# 1922357839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922357839 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA MEDICAL GROUP WORTHINGTON SURGERY CENTER |
| Practice Address |
1216 Ryans Rd Suite 2 Worthington MN 56187-1722 |
| Practice Telephone | 5073722921 |
| Practice Fax Number | 5073725789 |
| Mailing Telephone | 5073722921 |
| Mailing Fax Number | 5073725789 |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2015-06-03 |
| Authorized Official Name | KELLI VANGROUW (CLINIC MANAGER) |
| Authorized Official Telephone | 5073722921 |
| Is Organization Subpart | Y |
| Parent Organization Name | AVERA MCKENNAN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Avera Medical Group Worthington Surgery 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 |
1216 RYANS RD SUITE 2 |
| City | WORTHINGTON |
| State | MN |
| Zip Code | 56187-1722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306839022 | Benjamin Ernest Gaines | Obstetrics & Gynecology | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2005-08-28 |
| 1891335311 | Efrain Ocegueda | Dietitian, Registered | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2020-01-13 |
| 1629632443 | Debra Kay Behrends | Registered Nurse | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2019-04-26 |
| 1730563404 | Amir Makhmalbaf | Internal Medicine | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2015-07-13 |
| 1629472964 | Victoria Blanchette | Nurse Practitioner | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2014-10-15 |
| 1801226188 | Kristal Grigsby | Social Worker | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2013-11-22 |
| 1679826465 | Darlene Renee Dewitt | Dietitian, Registered | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2012-10-18 |
| 1609135367 | Katherine Elizabeth Smidt | Advanced Practice Midwife | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2012-05-15 |
| 1821319344 | Syed Asad Shah | Family Medicine | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2010-06-18 |
| 1609025717 | Archana S Bhat | Internal Medicine | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2008-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316224363 | Paul Michael Carlson | Dentist | 507 South Shore Drive, Worthington, MN 56187 | 2011-11-04 |
| 1912216540 | Nobles County Jail | Clinic/Center | 1530 Airport Road, Worthington, MN 56187 | 2010-09-30 |
| 1306984539 | Edward Thomas Mcniece | Dentist | 1027 Second Ave, Worthington, MN 56187 | 2007-02-01 |
| 1053338780 | Diagnostic Radiologic Imaging Pa | Radiology | 1607 N Mcmillan St, Ste 1, Worthington, MN 56187 | 2006-07-17 |
| 1427014232 | Scott James Hoffman | Podiatrist | 1205 Ryans Road, Worthington, MN 56187 | 2006-04-21 |
| 1588654404 | Jason Coy Turner | Pharmacist | 511 10th St, Worthington, MN 56187 | 2005-10-22 |
| 1518433879 | Nicole Block | Nurse Practitioner | 1680 Diagonal Rd, Worthington, MN 56187 | 2018-10-15 |
| 1033423322 | Rachael R Dekker | Nurse Practitioner | 1018 6th Ave, Worthington, MN 56187 | 2010-07-29 |
| 1417196601 | Jonathan Gabriel Eli-phillips | Obstetrics & Gynecology | 1018 6th Ave, Worthington, MN 56187 | 2009-02-11 |
| 1174716245 | Sanford Clinic | Radiology | 1018 6th Ave, Worthington, MN 56187 | 2007-08-22 |
| Find all providers in zip 56187 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079992 | Woodbury Surgery Center, LLC | Clinic/Center | 587 Bielenberg Dr Ste 100, Woodbury, MN 55125-4452 | 2020-10-09 |
| 1902410368 | Inspired Spine Surgcenter LLC | Clinic/Center | 7400 France Ave S Ste 102, Edina, MN 55435-4738 | 2020-09-03 |
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1215573209 | Hiawatha Surgery Center LLC | Clinic/Center | 2020 E 28th St Ste 100, Minneapolis, MN 55407-1453 | 2019-11-25 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1942760285 | Altru Health System Ambulatory Surgery Centers LLC | Clinic/Center | 400 S Minnesota St Ste B, Crookston, MN 56716-1808 | 2019-03-22 |
| 1396229746 | Avera Marshall | Clinic/Center | 1521 Carlson St Ste 200, Marshall, MN 56258-2626 | 2018-09-21 |
| 1891297925 | Pediatric Center Holdings, LLC | Clinic/Center | 15450 Highway 7 Ste 200, Minnetonka, MN 55345-3522 | 2018-03-05 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| Find all providers with the same taxonomy | ||||
| City | WORTHINGTON |
| Zip Code | 56187 |
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.