AVERA MCKENNAN (NPI# 1700905650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700905650 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AMG OCCUPATIONAL MEDICINE SIOUX FALLS |
| Practice Address |
4928 N Cliff Ave Sioux Falls SD 57104-0563 |
| Practice Telephone | 6053325100 |
| Practice Fax Number | 6053225101 |
| Mailing Telephone | 6053325100 |
| Mailing Fax Number | 6053225101 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2013-06-03 |
| Authorized Official Name | JULIE NORTON (SR VP FINANCE) |
| Authorized Official Telephone | 6053227818 |
| Is Organization Subpart | Y |
| Parent Organization Name | AVERA MCKENNAN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
5335 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | IA MEDICAL LICENSE | 33732 | 01 |
| SD | SD MEDICAL LICENSE | 5335 | 01 |
| Other Name | Type Code |
|---|---|
| AMG Occupational Medicine Sioux Falls | 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 |
4928 N CLIFF AVE |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57104-0563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336214402 | Bruce Alden Elkins | Preventive Medicine | 4928 N Cliff Ave, Sioux Falls, SD 57104-0563 | 2006-11-22 |
| 1366812976 | Sarah Fodness | Nurse Practitioner | 4928 N Cliff Ave, Sioux Falls, SD 57104-0563 | 2015-09-25 |
| 1891043550 | Sioux Falls Specialty Hospital, LLP | Special Hospital | 4928 N Cliff Ave, Sioux Falls, SD 57104-0563 | 2012-08-28 |
| 1376662825 | Avera Mckennan | Clinic/Center | 4928 N Cliff Ave, Sioux Falls, SD 57104-0563 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
| 1457995714 | Sanford Clinic | Clinic/Center | 1112 S Lake Ave, Ste 201, Sioux Falls, SD 57104 | 2019-10-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1033637210 | Anna Peasley | Speech-Language Pathologist | 710 W 18th St, Sioux Falls, SD 57104 | 2017-09-07 |
| 1699204313 | Sioux Falls Primary Home Care Services LLC | In Home Supportive Care | 201 N Minnesota Ave Ste 101l, Sioux Falls, SD 57104 | 2017-06-06 |
| 1093258808 | Megan Regina Wexler | Social Worker | 4510 N Lewis Ave, Sioux Falls, SD 57104 | 2016-11-28 |
| 1831645498 | Ryan Ortiz | Specialist/Technologist | 1908 1/2 Old Town Rd Nw, Albuquerque, NM 57104 | 2016-09-01 |
| 1881140622 | Kristine Carol Smith | Occupational Therapist | 601 N. Spring Ave, Hawthorne Elementary, Sioux Falls, SD 57104 | 2016-08-31 |
| 1215299292 | Jolene Mitchell | Preventive Medicine | 900 E 54th St N Ste 100, Sioux Falls, SD 57104 | 2012-06-14 |
| 1871874651 | Christine Marie Burg | Pharmacist | 2503 East 54th Street N., Medvantx Pharmacy Services, Sioux Falls, SD 57104 | 2011-09-07 |
| Find all providers in zip 57104 | ||||
| Taxonomy Code | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215299292 | Jolene Mitchell | Preventive Medicine | 900 E 54th St N Ste 100, Sioux Falls, SD 57104 | 2012-06-14 |
| 1336214402 | Bruce Alden Elkins | Preventive Medicine | 4928 N Cliff Ave, Sioux Falls, SD 57104-0563 | 2006-11-22 |
| 1811351802 | Rachel E Thies | Preventive Medicine | 900 E 54th St N Ste 200, Sioux Falls, SD 57104-0686 | 2016-04-06 |
| 1518963339 | John Alan Hansen Jr. | Preventive Medicine | 1310 W 22nd St, Ste Lower Level, Sioux Falls, SD 57105-1501 | 2005-06-27 |
| 1083610935 | Ronald Mark Rossing | Preventive Medicine | 900 E 54th St N, Sioux Falls, SD 57104-0681 | 2005-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891911632 | Occupational Health Network, Inc. | Preventive Medicine | 550 E Colorado Blvd, Spearfish, SD 57783-2776 | 2007-04-18 |
| City | SIOUX FALLS |
| Zip Code | 57104 |
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.