AVERA MCKENNAN (NPI# 1629175005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629175005 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA MCKENNAN DBA AVERA LAKEFIELD CLINIC |
| Practice Address |
1216 Ryans Rd Suite 1 Worthington MN 56187-1722 |
| Mailing Address |
221 3rd Ave N Lakefield MN 56150-1123 |
| Practice Telephone | 5073722921 |
| Practice Fax Number | 5073725789 |
| Mailing Telephone | 5073722921 |
| Mailing Fax Number | 5073725789 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-05-31 |
| Authorized Official Name | JULIE NORTON (CFO/SVP) |
| Authorized Official Telephone | 6053227818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Avera McKennan dba Avera Lakefield Clinic | Former Legal Business Name - Organization |
| Avera Medical Group Lakefield | 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 1 |
| 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 |
| 1922357839 | Avera Mckennan | Clinic/Center | 1216 Ryans Rd, Suite 2, Worthington, MN 56187-1722 | 2012-09-06 |
| 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 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598206757 | Riverside Chiropractic Center, Inc | Clinic/Center | 7100 N High St, Ste 202, Worthington, OH 43085-2316 | 2017-03-20 |
| 1023554474 | Varckette Family Chiropractic | Clinic/Center | 870 High St, Worthington, OH 43085-4139 | 2017-01-10 |
| 1023377892 | Greene County Chiropractic LLC | Clinic/Center | 6 N Commercial St, Worthington, IN 47471-1415 | 2012-05-14 |
| 1841372125 | Avera Mckennan | Clinic/Center | 508 10th St, Worthington, MN 56187-2343 | 2006-10-19 |
| 1093812471 | Avera Mckennan | Clinic/Center | 1216 Ryans Rd, Suite 1, Worthington, MN 56187-1722 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191403 | Cham Clinic LLC | Clinic/Center | 7362 University Ave Ne Ste 206, Fridley, MN 55432-3151 | 2020-10-15 |
| 1003434622 | Lost Lake Optical Company | Clinic/Center | 5240 Shady Island Cir, Mound, MN 55364-9222 | 2020-07-09 |
| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
| 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.