AVERA MCKENNAN (NPI# 1770753246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770753246 |
Entity Type | Organization |
Organization Name | AVERA MCKENNAN |
Other Organization Name | AVERA MCKENNAN RENAL TRANSPLANT CENTER |
Practice Address |
1417 S Cliff Ave Suite 302 Sioux Falls SD 57105-1062 |
Practice Telephone | 6053228000 |
Practice Fax Number | 6053226499 |
Mailing Telephone | 6053227350 |
Mailing Fax Number | 6053227351 |
Enumeration Date | 2008-03-11 |
Last Update Date | 2019-12-10 |
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 | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
10563 | SD | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Avera McKennan Renal Transplant 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 |
1417 S CLIFF AVE SUITE 302 |
City | SIOUX FALLS |
State | SD |
Zip Code | 57105-1062 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619972783 | Christopher Michael Hurley | Internal Medicine | 1417 S Cliff Ave, Suite 300, Sioux Falls, SD 57105-1022 | 2005-06-16 |
1538533427 | Christina Jean Pekoske | Physician Assistant | 1417 S Cliff Ave, Suite 101, Sioux Falls, SD 57105-1022 | 2015-11-16 |
1386045862 | Tabitha Marie Ammann | Nurse Practitioner | 1417 S Cliff Ave, Suite #101a, Sioux Falls, SD 57105-1022 | 2014-09-15 |
1144635988 | Katelin Marie Soodsma | Nurse Practitioner | 1417 S Cliff Ave, Suite 101a, Sioux Falls, SD 57105-1063 | 2014-06-30 |
1568700631 | Kali Swift | Genetic Counselor, MS | 1417 S Cliff Ave, Suite 100, Sioux Falls, SD 57105-1022 | 2013-01-24 |
1376716647 | Annette Lee Siewert | Obstetrics & Gynecology | 1417 S Cliff Ave, Ste. 401, Sioux Falls, SD 57105-1022 | 2008-04-08 |
1619176328 | Amber Ray Saloum | Obstetrics & Gynecology | 1417 S Cliff Ave, Suite 401, Sioux Falls, SD 57105-1064 | 2007-07-12 |
1760691794 | Cristina Alison Hill Jensen | Internal Medicine | 1417 S Cliff Ave, Ste 300, Sioux Falls, SD 57105-1062 | 2007-05-22 |
1588871859 | Jason Lewis Picconi | Medical Genetics | 1417 S Cliff Ave, Plaza 1, Suite 100, Sioux Falls, SD 57105-1022 | 2007-05-17 |
1639240732 | Leslie N. Heddleston | Obstetrics & Gynecology | 1417 S Cliff Ave, Ste 100, Sioux Falls, SD 57105-1063 | 2006-11-11 |
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 | 261QE0700X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | End-Stage Renal Disease (ESRD) Treatment |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033178660 | Total Renal Care Inc | Clinic/Center | 2326 W 69th St, Sioux Falls, SD 57108-5600 | 2006-03-22 |
1881110484 | Sanford Medical Center | Clinic/Center | 1321 W 22nd St, Sioux Falls, SD 57105-1502 | 2017-08-16 |
1710316252 | Avera Mckennan | Clinic/Center | 1315 S Cliff Ave, Ste 4000, Sioux Falls, SD 57105-1058 | 2013-11-05 |
1912921438 | Sanford Medical Center | Clinic/Center | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2006-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437502614 | Total Renal Care Inc | Clinic/Center | 3313 6th Ave Se, Aberdeen, SD 57401-5504 | 2016-07-22 |
1922318666 | Dialysis Management Group LLC | Clinic/Center | Hcr 49, Porcupine, SD 57772-0000 | 2010-10-15 |
1255415246 | Monument Health Rapid City Hospital, Inc. | Clinic/Center | 132 Yankee St, Spearfish, SD 57783-2948 | 2006-10-25 |
1184711061 | Total Renal Care | Clinic/Center | 400 Park, Gregory, SD 57533 | 2006-10-10 |
1710087713 | Black Hills Dialysis, LLC | Clinic/Center | 100 Dialysis Drive, Pine Ridge, SD 57770-3013 | 2006-09-22 |
1356301519 | Total Renal Care Inc | Clinic/Center | 1 Soldier Creek Rd, Rosebud, SD 57570-0610 | 2006-03-23 |
1477512093 | Total Renal Care Inc | Clinic/Center | 819 E Spruce St, Ste 100, Mitchell, SD 57301-4800 | 2006-03-22 |
1487621116 | Monument Health Rapid City Hospital, Inc. | Clinic/Center | 640 Flormann St Ste 401, Rapid City, SD 57701-4679 | 2006-03-01 |
1952841629 | Avera Mckennan | Clinic/Center | 301 Flynn Dr, Ste 4, Milbank, SD 57252-1508 | 2017-03-01 |
1235673948 | Fresenius Medical Care Dakota Dunes, LLC | Clinic/Center | 357 W Tower Rd, Dakota Dunes, SD 57049-5018 | 2016-12-14 |
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.